血清FGF-21、AHSG表达异常与糖尿病肾病肾损伤严重程度和肾功能下降的关系  

Relationship between abnormal expression of serum FGF-21 and AHSG and severity of renal injury and decline of renal function in patients with diabetes nephropathy

作　　者：侯波 肖小艳 丘江 叶刚 Hou Bo;Xiao Xiaoyan;Qiu Jiang;Ye Gang(Department of Endocrinology,Hubei Jianghan Oifield General Hospital,Qianjang 433124,China;Department of Radiology,Hubei Jianghan Oilfield General Hospital,Qianjiang 433124,China;Medical Laboratory,Hubei Jianghan Oifield General Hospital,Qianjang 433124,China;Department of Nephrology,Wuhan University Tongren Hospital,Wuhan Third Hospital,Wuhan 430060,China)

机构地区：[1]湖北江汉油田总医院内分泌科,潜江433124 [2]湖北江汉油田总医院放射影像科,潜江433124 [3]湖北江汉油田总医院医学检验科,潜江433124 [4]武汉市第三医院武汉大学同仁医院肾内科,武汉430060

出　　处：《国际泌尿系统杂志》2023年第6期1098-1102,共5页International Journal of Urology and Nephrology

摘　　要：目的分析血清成纤维细胞生成因子(FGF-21)、血清胎球蛋白A(AHSG)表达异常与糖尿病肾病(DN)患者肾损伤严重程度和肾功能下降的关系。方法选择湖北江汉油田总医院2018年1月至2020年2月间收治的80例DN患者作为观察组, 选择同期47例未出现DN的糖尿病患者作为糖尿病组, 并选取同期50例体检健康者作为对照组;检测受试者血中的FGF-21、AHSG表达水平;根据微量白蛋白与肌酐比值(UACR)表达水平将患者按肾损伤程度分为轻度白蛋白升高组(11例)、中度白蛋白升高组(40例)及重度白蛋白升高组(29例)。根据肾功能下降情况将患者分为肾功能下降迅速组(24例)、非肾功能下降迅速组(56例);采用Pearson相关分析FGF-21、AHSG水平变化与肾损伤的相关性, 采用受试者工作特征(ROC)曲线评价血清FGF-21、AHSG水平对DN患者肾功能下降迅速的评估价值。结果观察组的血清FGF-21水平高于糖尿病组和对照组, 观察组的AHSG表达水平低于糖尿病组和对照组, 差异均有统计学意义(均P<0.05);肾损伤轻度白蛋白升高组和中度白蛋白升高组患者的FGF-21水平明显低于重度白蛋白升高组, 两组AHSG水平明显高于重度白蛋白升高组, 差异均有统计学意义(均P<0.05);FGF-21与DN患者肾损伤呈正相关, AHSG与DN患者肾损伤呈负相关, 差异均有统计学意义(r=0.843、-0.794, 均P<0.05);肾功能下降迅速组患者血中FGF-21水平明显低于非肾功能下降迅速组, AHSG水平明显高于非肾功能下降迅速组, 差异均有统计学意义(t=18.209、6.241, 均P<0.05);FGF-21、AHSG水平对DN患者肾功能下降迅速评估的ROC曲线下面积(AUC)均>0.85。结论血清FGF-21、AHSG表达异常与DN患者肾损伤严重程度和肾功能降低呈明显相关性, 且对DN患者肾功能下降迅速的评估具有较高临床价值。Objective To analyze the relationship between the abnormal expression of serum fibroblast growth factor 21(FGF-21)and serum fetuin A(AHSG)and the severity of renal injury and the decline of renal function in patients with diabetic nephropathy(DN).Methods A total of 80 patients with DN admitted to Hubei Jianghan Oilfield General Hospital from January 2018 to February 2020 were selected as the observation group,47 patients with diabetes without DN were selected as the diabetes group,and 50 healthy subjects were selected as the control group.The expression levels of FGF-21 and AHSG in blood were detected.The patients were divided into mild albumin elevated group(1l cases),moderate albumin elevated group(40 cases)and severe albumin elevated group(29 cases)according to the degree of kidney injury according to the expression level of urinary albumin/creatinine ratio(UACR).According to the decline of renal function,the patients were divided into rapid decline of renal function group(24 cases)and non-rapid decline of renal function group(56 cases).Pearson correlation was used to analyze the correlation between changes in FGF-21 and AHSG levels and kidney injury,and receiver operating characteristic(ROC)curve was used to evaluate the value of serum FCF-21 and AHSG levels in the assessment of rapid renal function decline in patients with DN.Results The serum FCF-21 level in observation group was higher than that in diabetic group and control group,and the expression level of AHSG in observation group was lower than that in diabetic group and control group,with statistical significance(all P<0.05).The level of FGF-21 in mild albumin elevated group and moderate albumin elevated group was significantly lower than that in severe albumin elevated group,and the level of AHSG in both groups was significantly higher than that in severe albumin elevated group,with statistical significance(all P<0.05).There was a significant positive correlation between FCF-21 and kidney injury in DN patients,and a significant negative correlation b

关 键 词：糖尿病肾病 肾功能 肾损伤 FGF-21 AHSG 

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