晚期糖基化终末产物及其受体半乳糖凝集素-3与糖尿病肾病的相关性及诊断价值研究  

Study on the correlation and diagnostic value of advanced glycation end products and their receptor galactolectin-3 with diabetic kidney disease

作　　者：孙紫娟 赏石丽 沈待羽 陈靖珊 毕莉娜 罗莎 李俊[1] SUN Zijuan;SHANG Shili;SHEN Daiyu;CHEN Jingshan;BI Lina;LUO Sha;LI Jun(Department of Nephrology,the First Affiliated Hospital of Kunming Medical University,Yunnan Province,Kunming650032,China)

机构地区：[1]昆明医科大学第一附属医院肾内科,云南昆明650032

出　　处：《中国当代医药》2023年第7期7-11,17,F0003,共7页China Modern Medicine

基　　金：国家级大学生创新创业训练计划项目(202010678065);云南省科技计划项目[2017FE467(-041)];云南省高层次人才培养支持计划“名医专项”项目(RLMY20200022);昆明医科大学研究生创新基金资助项目(2020S149)。

摘　　要：目的探究晚期糖基化终末产物(AGEs)及其受体半乳糖凝集素-3(Gal-3)与糖尿病肾病(DKD)的相关性及诊断价值。方法选取2020年1月至2021年3月昆明医科大学第一附属医院收治的80例DKD患者为DKD组,选取同期60例原发性肾小球肾炎(PGN)患者为PGN组,30例2型糖尿病(T2DM)患者为T2DM组,30例健康体检者为健康对照(NC)组,根据估算肾小球滤过率(eGFR)将DKD组分为G_(1)~G_(5)期。回顾性收集四组研究对象的一般资料(性别、年龄)及实验室指标[血清尿素氮(BUN)、血肌酐(SCr)、尿酸(UA)、空腹血糖(FPG)及尿白蛋白肌酐比(UACR)],计算eGFR,测定血清AGEs、Gal-3水平,分析比较四组患者及DKD组G_(1)~G_(5)期的上述研究资料水平,采用Spearman相关性分析及logistic回归分析探究上述指标与DKD的相关性及发生DKD的独立危险因素,绘制受试者工作特征曲线(ROC)分析血清AGEs和Gal-3单独及联合检测对DKD的诊断价值。结果四组患者的血清AGEs、Gal-3水平比较,差异有统计学意义(P<0.05);DKD组的血清AGEs、Gal-3水平均高于PGN组、T2DM组及NC组,差异有统计学意义(P<0.05)。DKD组G_(1)~G_(5)期的血清AGEs、Gal-3水平比较,差异有统计学意义(P<0.05);G_(1)期的血清AGEs、Gal-3水平低于G_(3)、G_(4)、G_(5)期,G_(2)期的血清AGEs、Gal-3水平低于G_(5)期,差异有统计学意义(P<0.05)。DKD组的血清AGEs、Gal-3分别与BUN、SCr、UA、UACR呈正相关(P<0.05),与FPG、eGFR呈负相关(P<0.05);AGEs与Gal-3水平呈正相关(r=0.774,P<0.05)。logistic回归分析显示,FPG(β=0.829,OR=2.290,95%CI=1.680~3.123)、AGEs(β=0.028,OR=1.029,95%CI=1.005~1.053)及Gal-3(β=0.069,OR=1.071,95%CI=1.040~1.102)是DKD发生的独立危险因素(P<0.05)。AGEs、Gal-3单独用于诊断DKD的曲线下面积(AUC)分别为0.812及0.865,二者联合诊断的曲线下面积为0.870。结论血清AGEs、Gal-3是DKD发生的独立危险因素且在DKD中高表达,随着肾功能减退逐渐升高,二者联合检测可提高DKD的�Objective To investigate the relationship between advanced glycation end products(AGEs)and their receptor galectin-3(Gal-3)with diabetic kidney disease(DKD)and their diagnostic value.Methods A total of 80 patients with DKD admitted to the First Affiliated Hospital of Kunming Medical University from January 2020 to March 2021 were selected as DKD group,60 patients with primary glomerulonephritis(PGN)were selected as PGN group,30 patients with type 2 diabetes mellitus(T2DM)were selected as T2DM group,and 30 healthy people were selected as normal control(NC)group at the corresponding period.According to the estimated glomerular filtration rate(eGFR),the DKD group was divided into G_(1)-G_(5)stages.The general data(gender,age)and laboratory parameters(blood urea nitrogen[BUN],serum creatinine[SCr],uric acid[UA],fasting plasma glucose[FPG]and urinary albumin creatinine ratio[UACR])of the four groups were retrospectively collected,eGFR was calculated,and serum AGEs and Gal-3 levels were measured.Spearman correlation analysis and logistic regression analysis were used to explore the correlation with DKD and the independent risk factors.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum AGEs and Gal-3 alone and in combination for DKD.Results The levels of serum AGEs and Gal-3 in four groups were significantly different(P<0.05).Serum AGEs and Gal-3 levels in DKD group were higher than those in PGN group,T2DM group and NC group,and the differences were statistically significant(P<0.05).The levels of serum AGEs and Gal-3 in G_(1)to G_(5)stage in DKD group were significantly different(P<0.05).Serum levels of AGEs and Gal-3 in G_(1)stage were lower than those in G_(3),G_(4)and G_(5)stages,while those in G_(2)stage were lower than those in G_(5)stage,and the differences were statistically significant(P<0.05).Serum AGEs and Gal-3 in DKD group were positively correlated with BUN,SCr,UA and UACR(P<0.05),and negatively correlated with FPG and eGFR(P<0.05).AGEs were positively correlated

关 键 词：糖尿病肾病 糖基化终末产物 半乳糖凝集素-3 相关性 诊断价值 

分 类 号：R692.9[医药卫生—泌尿科学] R587.2[医药卫生—外科学]