探讨HbA1c、C肽和尿NAG对2型糖尿病早期肾损伤的诊断价值  

Diagnostic Value of HbA1c,C-peptide and Urinary NAG in Early Renal Injury in Type 2 Diabetes Mellitus

作　　者：许焕 张娟[1] 孙玉璇 XU Huan;ZHANG Juan;SUN Yuxuan(Department of Laboratory Medicine,Peixian Hospital of Traditional Chinese Medicine,Peixian,Jiangsu Province,221600 China)

机构地区：[1]沛县中医院检验科,江苏沛县221600

出　　处：《糖尿病新世界》2023年第10期183-186,共4页Diabetes New World Magazine

摘　　要：目的探讨糖化血红蛋白(glycosylated hemoglobin,HbA1c)、C肽、尿N-乙酰-β-D-氨基葡萄糖苷酶(uri⁃nary N-acetyl-β-D-glucaminoglycosidase,NAG)指标检测在2型糖尿病早期肾损伤诊断中的应用价值。方法选取2022年2—12月沛县中医院收治的98例糖尿病患者为研究组,并依据患者是否出现肾损伤分成单纯糖尿病组(n=63)、早期肾损伤组(n=35)。另在同期健康体检者中选取98名志愿者为对照组。对比观察组、对照组患者的HbA1c、C肽、NAG指标水平,其次对比观察组中单纯糖尿病组、早期肾损伤组患者的HbA1c、C肽、NAG指标水平。分析HbA1c、C肽、NAG及联合检测在早期肾损伤诊断中的灵敏度、特异度。结果观察组HbA1c、NAG水平高于对照组,C肽指标低于对照组,差异有统计学意义(P<0.05)。早期肾损伤组HbA1c、NAG水平高于单纯糖尿病组,C肽指标低于单纯糖尿病组,差异有统计学意义(P<0.05)。HbA1c、C肽、NAG指标联合检测的灵敏度高于HbA1c、C肽、NAG指标3项指标单独检测。HbA1c、C肽、NAG及联合检测在糖尿病肾损伤诊断中曲线下面积(AUC)分别为0.615、0.726、0.795、0.935。结论HbA1c、C肽、NAG指标在糖尿病早期肾损伤的诊断中具有较高价值,能帮助医师及早发现糖尿病患者的肾损伤情况,尤其是3项指标联合检测具有较高的灵敏度和特异度。Objective To investigate the diagnostic value of glycosylated hemoglobin(HbA1c),C-peptide and urinary N-acetyl-β-D-glucaminoglycosidase(NAG)in early renal injury of type 2 diabetes mellitus.Methods Ninety-eight patients with diabetes admitted to Peixian Hospital of Traditional Chinese Medicine from February to December 2022 were selected as the study group,and were divided into simple diabetes group(n=63)and early kidney injury group(n=35)according to whether the patients had kidney injury.In addition,98 healthy volunteers were selected as control group during the same period.The levels of HbA1c,C-peptide and NAG indexes in the observation group and the con-trol group were compared,followed by the levels of HbA1c,C-peptide and NAG indexes in the observation group of patients with simple diabetes and early kidney injury.The sensitivity and specificity of HbA1c,C-peptide,NAG and combined detection in early diagnosis of kidney injury were analyzed.Results The levels of HbA1c and NAG in the ob-servation group were higher than those in the control group,and the index of C-peptide was lower than that in the con-trol group,the difference was statistically significant(P<0.05).The levels of HbA1c and NAG in early renal injury group were higher than those in simple diabetes group,and the C-peptide index was lower than that in simple diabe-tes group,the difference was statistically significant(P<0.05).The sensitivity of HbA1c,C-peptide and NAG com-bined was higher than that of HbA1c,C-peptide and NAG separately.The area under the curve(AUC)of HbA1c,C-peptide,NAG and combined tests were 0.615,0.726,0.795 and 0.935,respectively.Conclusion HbA1c,C-peptide and NAG are of high value in the diagnosis of early renal injury in diabetes,which can help physicians to detect early kidney injury in diabetic patients.In particular,the combined detection of the three indexes has high sensitivity and specificity.

关 键 词：HBA1C C肽 NAG 生化检测 糖尿病 肾损伤 

分 类 号：R446.1[医药卫生—诊断学]