血浆可溶性CD146与2型糖尿病患者肾功能关系及对白蛋白尿短期进展的预测价值研究  

Relationship between plasma soluble CD146 and renal function in patients with type 2 diabetesmellitus and its predictive value for short-term progression of albuminuria

作　　者：李晶 屈勇  LI Jing;QU Yong;YAROV(Department of Endocrinology,XD Group Hospital,Xi’an 710077,China)

机构地区：[1]西电集团医院内分泌科,陕西西安710077 [2]陕西中医药大学,陕西咸阳712046

出　　处：《陕西医学杂志》2023年第3期282-286,共5页Shaanxi Medical Journal

基　　金：西安市科学技术局高端外国专家引进计划项目(G2022041016L)。

摘　　要：目的:分析血浆可溶性CD146与2型糖尿病患者肾功能的关系及对白蛋白尿短期进展的预测价值。方法:选择2型糖尿病住院患者186例为研究对象,根据24 h尿白蛋白定量分为无白蛋白尿组(<20 mg/24 h,86例)、微量白蛋白尿组(20~200 mg/24 h,68例)和大量白蛋白尿组(>200 mg/24 h,32例),比较三组一般资料及实验室指标。随访12个月后,根据白蛋白尿进展情况将患者分为白蛋白尿进展组和非进展组,比较两组患者一般资料及实验室指标。分析血浆可溶性CD146与血肌酐(Scr)、肾小球滤过率(GFR)的相关性。分析2型糖尿病患者白蛋白尿短期进展的危险因素,并使用多重模型校正相关混杂因素。评价血浆可溶性CD146对白蛋白尿短期进展的预测价值。结果:随着2型糖尿病患者尿白蛋白含量增加,无白蛋白尿组、微量白蛋白尿组及大量白蛋白尿组血浆可溶性CD146水平依次升高(均P<0.05)。与无白蛋白尿组和微量白蛋白尿组比较,大量白蛋白尿组Scr水平更高,GFR水平更低(均P<0.05)。186例患者均获得随访,其中白蛋白尿短期进展48例,归入白蛋白尿进展组,其余138例归入白蛋白尿非进展组。白蛋白尿进展组Scr及血浆可溶性CD146水平高于白蛋白尿非进展组,GFR水平低于白蛋白尿非进展组(均P<0.05)。经Pearson相关性分析,2型糖尿病患者血浆可溶性CD146水平与Scr水平呈正相关(r=0.259,P=0.013),与GFR呈负相关(r=-0.316,P=0.000)。经多因素Logistic回归分析并校正混杂因素,血浆可溶性CD146水平是2型糖尿病患者白蛋白尿短期进展的独立危险因素(P<0.05)。经受试者工作特征(ROC)曲线分析,血浆可溶性CD146水平对2型糖尿病患者白蛋白尿短期进展具有较高的预测价值,高于Scr和GFR(Z=2.642、2.239,均P<0.05)。结论:血浆可溶性CD146可以反映2型糖尿病患者肾功能,对白蛋白尿短期进展有一定的预测价值。Objective:To analyze the relationship between plasma soluble CD146 and renal function in patients with type 2 diabetes mellitus and its predictive value for short-term progression of albuminuria.Methods:A total of 186 inpatients with type 2 diabetes mellitus were selected and divided into no non-albuminuria group(<20 mg/24 h,86 cases),microalbuminuria group(20 to 200 mg/24 h,68 cases)and large albuminuria group(>200 mg/24 h,32 cases)according to the 24-hour urine albumin quantitative,and general data and laboratory parameters were compared between three groups.After 12 months of follow-up,patients were divided into progressive albuminuria group and non-progressive albuminuria group based on albuminuria progression,and general data and laboratory parameters were compared between two groups.The association of plasma soluble CD146 with Scr and GFR was analyzed.Risk factors for short-term progression of albuminuria in patients with type 2 diabetes were analyzed,and multiple models were used to adjust for associated confounders.The predictive value of plasma soluble CD146 for the short-term progression of albuminuria was evaluated.Results:The plasma soluble CD146 level increased sequentially in non-albuminuria,microalbuminuria,and large albuminuria groups in patients with type 2 diabetes mellitus(all P<0.05).Compared with non-albuminuria and microalbuminuria groups,large albuminuria group had higher level of Scr and lower level of GFR(all P<0.05).A total of 186 patients were followed up,of whom 48 had short-term progression of albuminuria,which was classified as progressive albuminuria group,and 138 as non-progressive albuminuria group.The levels of Scr and plasma soluble CD146 in progressive albuminuria group were higher than those in non-progressive albuminuria group,and the level of GFR was lower than that in non-progressive albuminuria group(all P<0.05).Pearson correlation analysis showed that plasma soluble CD146 level was positively correlated with Scr level in patients with type 2 diabetes(r=0.259,P=0.013)and n

关 键 词：2型糖尿病 糖尿病肾病 可溶性CD146 肾功能 白蛋白尿 预测价值 

分 类 号：R587.1[医药卫生—内分泌]