核苷酸结合寡聚化结构域样受体蛋白3炎性小体和1-磷酸鞘氨醇对早期糖尿病肾病及其进展情况的诊断价值研究  

Diagnostic value of nucleotide-binding oligomerization domain-like receptor protein 3 inflammatory body and sphingosine-1-phosphate in early diabetic nephropathy and its progression

作　　者：林燕[1] 李婧 余湘尤 刘玲娇[1] 闫妮 段朝阳[2] LIN Yan;LI Jing;YU Xiangyou;LIU Lingjiao;YAN Ni;DUAN Chaoyang(Department of Endocrinology,Shaanxi Provincial People’s Hospital,Xi’an,Shaanxi 710068,P.R.China;Department of Nephrology,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an,Shaanxi 710004,P.R.China)

机构地区：[1]陕西省人民医院内分泌科,西安710068 [2]西安交通大学第二附属医院肾病科,西安710004

出　　处：《华西医学》2022年第7期1035-1040,共6页West China Medical Journal

基　　金：陕西省自然科学基础研究计划(2018JM7143)。

摘　　要：目的探讨核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)炎性小体和1-磷酸鞘氨醇(sphingosine-1-phosphate,S1P)对早期糖尿病肾病及其进展情况的诊断价值。方法选择2018年1月-2020年12月在陕西省人民医院就诊的600例糖尿病患者,将患者分为单纯糖尿病组、早期糖尿病肾病组和临床糖尿病肾病组。采用实时荧光定量聚合酶链反应检测患者空腹静脉血单个核细胞NLRP3信使RNA(messenger RNA,mRNA)表达情况,酶联免疫吸附测定双抗体夹心法检测S1P水平。采用Pearson相关性分析探讨血NLRP3 mRNA和S1P水平的相关性。采用受试者操作特征曲线评价血NLRP3 mRNA和S1P水平对早期糖尿病肾病以及临床糖尿病肾病的诊断价值。结果600例糖尿病患者中单纯糖尿病组205例、早期糖尿病肾病组198例和临床糖尿病肾病组197例。3组患者的年龄和性别差异无统计学意义(P>0.05)。临床糖尿病肾病组患者血NLRP3 mRNA和S1P水平高于早期糖尿病肾病组和单纯糖尿病组,早期糖尿病肾病组患者血NLRP3 mRNA和S1P水平高于单纯糖尿病组,差异有统计学意义[3组患者血NLRP3 mRNA水平分别为2.69±0.64 vs.2.05±0.56 vs.1.76±0.51,S1P水平分别为(1.49±0.27)vs.(1.16±0.13)vs.(0.89±0.07)μmol/L,P<0.05]。患者血NLRP3 mRNA与S1P水平存在正相关关系(r=0.455,P<0.001)。患者血NLRP3 mRNA、S1P水平及二者联合检测均可用于诊断糖尿病患者是否发生早期糖尿病肾病(受试者操作特征曲线下面积分别为0.645、0.968、0.971;P<0.001)以及是否进展至临床糖尿病肾病(受试者操作特征曲线下面积分别为0.825、0.918、0.945;P<0.001)。结论血NLRP3 mRNA和S1P水平可用于诊断早期糖尿病肾病并评估其病情进展情况。Objective To investigate the diagnostic value of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammatory body and sphingosine-1-phosphate(S1P)in early diabetic nephropathy and its progression.Methods A total of 600 diabetic patients who were treated in Shaanxi Provincial People’s Hospital between January 2018 and December 2020 were selected,and the patients were divided into simple diabetes group,early diabetic nephropathy group and clinical diabetic nephropathy group.The expression of NLRP3 messenger RNA(mRNA)in fasting venous blood mononuclear cells was detected by real-time fluorescence quantitative polymerase chain reaction,and the level of S1P was detected by enzyme-linked immunosorbent assay double-antibody sandwich method.Pearson correlation analysis was used to explore the correlation between blood NLRP3 mRNA and S1P levels.The receiver operating characteristic curve was used to evaluate the diagnostic value of blood NLRP3 mRNA and S1P levels in early diabetic nephropathy and clinical diabetic nephropathy.Results Among the 600 diabetic patients,205were in the simple diabetes group,198 in the early diabetic nephropathy group and 197 in the clinical diabetic nephropathy group.There was no significant difference in age and gender among the three groups(P>0.05).The blood levels of NLRP3 mRNA and S1P in the clinical diabetic nephropathy group were higher than those in the early diabetic nephropathy group and the simple diabetes group,the blood NLRP3 mRNA and S1P levels in the early diabetic nephropathy group were higher than those in the simple diabetes group.The differences were statistically significant,and the blood NLRP3 mRNA levels of the three groups were 2.69±0.64 vs.2.05±0.56 vs.1.76±0.51,and the S1P levels were(1.49±0.27)vs.(1.16±0.13)vs.(0.89±0.07)μmol/L(P<0.05).There was a positive correlation between blood NLRP3mRNA and S1P level in patients(r=0.455,P<0.001).Blood NLRP3 mRNA,S1P levels and their combined detection can be used to diagnose whether diabetic patien

关 键 词：核苷酸结合寡聚化结构域样受体蛋白3炎性小体 1-磷酸鞘氨醇 糖尿病肾病 早期糖尿病肾病 诊断价值 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]