淋巴细胞与甘油三酯比值联合25(OH)D_(3)对糖尿病肾病早期诊断价值  

作　　者：李晓霞 王安娜 娄坚江 李丹娜 许健[2] 

机构地区：[1]浙江中医药大学附属绍兴市中医院,312000 [2]浙江中医药大学,310053

出　　处：《浙江临床医学》2024年第1期124-126,129,共4页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2022RC278)。

摘　　要：目的探讨淋巴细胞(L)和甘油三酯(TG)比值(L/TG)联合25-羟维生素D_(3)[25(OH)D_(3)]对糖尿病肾病(DN)早期诊断价值。方法收集2020年9月至2022年3月204例DN患者为观察组,同时收集年龄和性别匹配的健康对照者101例为对照组,检测两组尿微量白蛋白与肌酐比值(UACR)、肾小球滤过率(GFR)、L、TG、25(OH)D_(3)水平;观察组以UACR和GFR为依据分为4个亚组,包括DN轻风险组、中风险组、重风险组、极重风险组。采用Logistic回归进行多因素分析;通过ROC曲线确定最优指标。结果观察组GFR、25(OH)D_(3)、L/TG低于对照组,UACR、TG高于对照组(P<0.05);L/TG与25(OH)D_(3)存在相关性和一致性(r=0.16,P<0.001);DN轻风险组、中风险组、重风险组、极重风险组L/TG、25(OH)D_(3)水平逐渐递减,差异有统计学意义(P<0.05);Logistic回归分析显示,L/TG、25(OH)D_(3)是DN晚期的独立保护因素(P<0.05);ROC曲线显示两者单独检测的效能比较无统计学意义,但两者联合检测(AUC=0.857,95%CI:0.801~0.902)敏感性和特异度均高于单项检测。结论L/TG、25(OH)D_(3)与DN密切相关,两者联合检测表现出较高的准确度,有助于疾病的早期预防。Objective To explore the clinical application of lymphocyte(L)to triglyceride(TG)ratio combined with 25-hydroxyvitamin D_(3)[25(OH)D_(3)]in diabetic nephropathy(DN).Methods 204 patients with DN were collected in the investigate in Shaoxing Hospital of Traditional Chinese Medicine from September 2020 to March 2022,and 101 genderand age-matched data of healthy people were collected for the investigate,and the results of blood lipid levels,some urinary microalbumin-to-creatinine(UACR),glomerular filtration rate(GFR),L,TG,and 25(OH)D_(3)and inflammatory indexes were statistically analyzed using Mann Whitney U-test between two groups and Kruskal-Wallis H-test between multiple groups.The observation group was divided into 4 DN subgroups based on UACR and GFR,including light risk group,medium risk group,heavy risk group and extremely heavy risk group.Binary logistic regression was used for multivariate analysis.The optimal index was determined by the receiver working curve(ROC)curve.Results Mann Whitney U-test showed that the levels of total GFR,25(OH)D_(3)and L/TG in patients with DN were significantly lower than those in healthy controls,while the levels of UACR and TG in DN patients were significantly higher than those in healthy controls.The difference was statistically significant(P<0.05).There was a correlation and consistency between L/TG and 25(OH)D_(3)(r=0.16,P<0.001).In the observation group,Kruskal-Wallis H-test showed that the levels of L/TG and 25(OH)D_(3)in the light risk group,medium risk group,heavy risk group and extremely heavy risk group of DN gradually decreased,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that L/TG and 25(OH)D_(3)were independent protective factors for late DN(P<0.05).ROC curve showed that there was no significant difference in the efficacy of the two alone,but the AUC of the combined detection of the two was 0.857,95%CI:(0.801~0.902),and the sensitivity and specificity were higher than those of the single detection.Conclusion L/TG a

关 键 词：糖尿病肾病 淋巴细胞/甘油三酯比值 25-羟维生素D_(3) 尿微量白蛋白比肌酐 肾小球滤过率 

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