血清IGF-1、ATF3在糖尿病肾病患者中的表达及其与蛋白尿的关系  

The relationship between expression of serum IGF-1 and ATF3 in patients with diabetes nephropathy and proteinuria

作　　者：李沛玲[1] 杨兆凤[2] 卢海霞 LI Peiling;YANG Zhaofeng;LU Haixia(Department of Geriatrics,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Department of General Medicine,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Department of Nephrology,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院老年病科,宁夏银川750002 [2]宁夏回族自治区人民医院全科医学科,宁夏银川750002 [3]宁夏回族自治区人民医院肾内科,宁夏银川750002

出　　处：《宁夏医学杂志》2023年第11期961-964,F0002,共5页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(2022AAC03362)。

摘　　要：目的探讨糖尿病肾病患者血清血胰岛素样生长因子-1(IGF-1)、转录激活因子3(ATF3)水平与蛋白尿的相关性。方法纳入收治的100例糖尿病肾病患者,根据Mogensen分期和蛋白尿排泄率(UAER)将患者分为微量蛋白尿组(45例)和大量蛋白尿组(55例)。观察2组患者血清IGF-1、ATF3、尿素氮(BUN)、尿酸(UA)水平,通过ROC分析血清IGF-1、ATF3、UA、BUN预测糖尿病肾病患者发生大量蛋白尿的价值,然后通过多因素分析采取非条件logistic逐步回归分析明确糖尿病肾病患者发生大量蛋白尿的危险因素;相关性用Person系数分析。结果微量蛋白尿组患者IGF-1、ATF3、UA、BUN水平显著低于大量蛋白尿组(P<0.05);经ROC分析证实IGF-1、ATF3、UA、BUN可用于糖尿病肾病患者发生大量蛋白尿的预测,曲线下面积分别为0.911、0.893、0.861、0.887;多因素分析显示IGF-1≥226.618μg/L、ATF3≥1250.689 pg/mL、UA≥315.655μmol/L、BUN≥97.210 mmol/L是糖尿病肾病患者发生大量蛋白尿的危险因素;相关性分析显示IGF-1、ATF3、UA、BUN与蛋白尿均呈正相关(P<0.05)。结论糖尿病肾病患者蛋白尿与血清IGF-1、ATF3、UA、BUN水平呈正相关,且IGF-1≥226.618μg/L、ATF3≥1250.689 pg/mL、UA≥315.655μmol/L、BUN≥97.210 mmol/L可用于糖尿病肾病患者发生大量蛋白尿的预测。Objective To explore the correlation between serum insulin-like growth factor-1(IGF-1)and transcription activating factor-3(ATF3)levels and proteinuria in patients with diabetic nephropathy.Methods 100 patients with diabetes nephropathy were included and they were divided into microalbuminuria group(n=45)and macroalbuminuria group(n=55)according to Mogensen staging and proteinuria excretion rate(UAER).The levels of serum IGF-1,ATF3,urea nitrogen(BUN)and uric acid(UA)in two groups were observed,and the value of serum IGF-1,ATF3,UA and BUN in predicting massive proteinuria in patients with diabetic nephropathy was analyzed by ROC,and then the risk factors of massive proteinuria in patients with diabetic nephropathy were determined by unconditional logistic stepwise regression analysis through multivariate analysis.Results The level of IGF-1,ATF3,UA and BUN in microalbuminuria group were significantly lower than those in macroalbuminuria group(P<0.05).ROC analysis confirmed that IGF-1,ATF3,UA and BUN were used to predict the occurrence of massive proteinuria in patients with diabetic nephropathy,and the areas under the curve were 0.911,0.893,0.861 and 0.887 respectively.Multifactor analysis showed that IGF-1≥226.618μg/L,ATF3≥1250.689 pg/mL,UA≥315.655μmol/L and BUN≥97.210 mmol/L were the risk factors for proteinuria in patients with diabetic nephropathy.Correlation analysis showed that IGF-1,ATF3,UA and BUN were positively correlated with proteinuria(P<0.05).Conclusion There is a positive correlation between proteinuria in patients with diabetic nephropathy and serum levels of IGF-1,ATF3,UA and BUN,and when IGF-1≥226.618μg/L,ATF3≥1250.689 pg/mL,UA≥315.655μmol/L and BUN≥97.210 mmol/L can be used to predict massive proteinuria in patients with diabetic nephropathy.

关 键 词：糖尿病肾病 血胰岛素样生长因子-1 转录激活因子3 蛋白尿 相关性 

分 类 号：R277.5[医药卫生—中医学]