T2DM患者尿β2-MG及血清OST、25(OH)D3水平与糖尿病肾病发病风险的关系  

Relationship between the expression of urinary β2⁃MG and serum OST,25(OH)D3 levels and the risk of diabetic nephropathy in patients with T2DM

作　　者：郭玲 丁静贤 GUO Ling;DING Jingxian(Department of Nutrition,Changzhou Wujin Hospital of Traditional Chinese Medicine,Changzhou,Jiangsu,China,213000;Wujin Department of Endocrinology,Changzhou,Jiangsu,China,213000)

机构地区：[1]常州市武进中医医院营养科,江苏常州213000 [2]常州市武进中医医院内分泌科,江苏常州213000

出　　处：《分子诊断与治疗杂志》2023年第10期1694-1697,1702,共5页Journal of Molecular Diagnostics and Therapy

基　　金：常州市第十一批科技计划(社会发展科技支撑)(CE20215044)。

摘　　要：目的探讨2型糖尿病(T2DM)患者尿β2微球蛋白(β2⁃MG)及血清骨钙素(OST)、25羟基维生素D3[25(OH)D3]水平及与糖尿病肾病(DKD)发病风险的关系。方法选取2018年1月至2022年7月常州市武进中医医院收治的DKD患者112例(DKD组)、单纯T2DM患者53例(T2DM组)、同期在医院体检的健康志愿者49名(对照组)为研究对象,比较三组临床资料、尿β2⁃MG、血清OST、25(OH)D3、血清肌酐(Scr)、尿素氮(BUN)及肾小球滤过率(eGFR)水平,采用Pearson相关模型分析尿β2⁃MG、血清OST、25(OH)D3与肾功能指标相关性;采用Logistic回归模型分析影响DKD的因素;绘制ROC曲线分析尿β2⁃MG、血清OST、25(OH)D3对DKD的预测价值。结果尿β2⁃MG、血清Scr及BUN水平比较,DKD组>T2DM组>对照组,差异有统计学意义(P<0.05),eGFR、血清OST及25(OH)D3水平比较,DKD组<T2DM组<对照组,差异有统计学意义(P<0.05);Pearson显示,尿β2⁃MG与Scr及BUN呈正相关,与eGFR呈负相关,血清OST及25(OH)D3与Scr及BUN呈负相关,与eGFR呈正相关(P均<0.05);Logistic分析显示,Scr、BUN、尿β2⁃MG、血清OST及25(OH)D3是DKD的独立影响因素;ROC曲线显示,尿β2⁃MG、血清OST及25(OH)D3单一及联合预测DKD的下曲线面积分别为0.831、0.894、0.763、0.936。结论T2DM患者尿β2⁃MG、血清OST及25(OH)D3水平与肾功能密切相关,并参与DKD的发病机制,是DKD发生的影响因素。Objective To investigate the relationship between urinaryβ2⁃MG,serum OST,25(OH)D3 levels and the risk of DKD in patients with T2DM.Methods A total of 112 patients with DKD(DKD group),53 patients with simple T2DM(T2DM group)and 49 healthy volunteers(control group)who underwent physical examination in Changzhou Wujin Hospital of Traditional Chinese Medicine from January 2018 to July 2022 were selected as the research objects.The clinical data,urinaryβ2⁃MG,serum OST,25(OH)D3,serum Scr,BUN and eGFR levels were compared among the three groups.Pearson correlation model was used to analyze the correlation between urinaryβ2⁃MG,serum OST,25(OH)D3 and renal function indexes.A logistic regression model was used to analyze the factors affecting DKD.The ROC curve was drawn to analyze the predictive value of urinaryβ2⁃MG,serum OST and 25(OH)D3 for DKD.Results The levels of urinaryβ2⁃MG,serum Scr and BUN were compared,DKD group>T2 DM group>control group,the difference was statistically significant(P<0.05).The levels of eGFR,serum OST and 25(OH)D3 were compared,DKD group<T2DM group<control group,the difference was statistically significant(P<0.05).Pearson showed that urinaryβ2⁃MG was positively correlated with Scr and BUN,and negatively correlated with eGFR.Serum OST and 25(OH)D3 were negatively correlated with Scr and BUN,and positively correlated with eGFR(P<0.05).Logistic analysis showed that Scr,BUN,urinaryβ2⁃MG,serum OST and 25(OH)D3 were independent influencing factors of DKD.The ROC curve showed that the area under the curve of urinaryβ2⁃MG,serum OST and 25(OH)D3 for single and combined prediction of DKD were 0.831,0.894,0.763 and 0.936,respectively.Conclusion The levels of urinaryβ2⁃MG,serum OST and 25(OH)D3 in T2DM patients are closely related to renal function and participate in the pathogenesis of DKD,which are the influencing factors of DKD.

关 键 词：Β2微球蛋白 骨钙素 25羟基维生素D3 2型糖尿病 糖尿病肾病 

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