HbA1c、Betatrophin对2型糖尿病肾脏疾病相关性及诊断价值研究  

Correlation and Diagnostic Value Between HbA1c, Betatrophin and Type 2 Diabetic Kidney Disease

作　　者：杨录波 叶韬[2] 李丽敏 李桂平[4] 崔丽娟 马玲娣[5] 王伟佳 YANG Lubo;YE Tao;LI Limin(Guangdong Medical University,Zhanjiang,Guangdong,524000)

机构地区：[1]广东医科大学,湛江524000 [2]深圳市宝安区人民医院内分泌科,深圳518101 [3]中山市人民医院检验科,中山528403 [4]惠州市第三人民医院内分泌科,惠州516002 [5]惠州市第三人民医院检验科,惠州516002

出　　处：《中国中西医结合肾病杂志》2024年第4期319-322,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：中山市重大科研专项项目(No.2021B3013);惠州市科技计划项目(No.2019Y209)。

摘　　要：目的:分析糖化血红蛋白(HbA1c)和促代谢因子(Betatrophin)与2型糖尿病肾脏疾病(DKD)的相关性,及对DKD早期诊断的临床意义。方法:回顾性分析2021年10月—2022年06月期间在我院内分泌科住院的2型糖尿病(T2DM)患者90例。依据尿微量白蛋白与肌酐比值(ACR)分为:正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组,各30例;同期随机抽取30例健康体检者作为对照组。收集患者一般资料与常规检测指标,分析HbA1c、Betatrophin与上述指标相关性,运用Logistic回归和ROC曲线分析HbA1c、Betatrophin联合检测在DKD诊断中的应用价值。结果:四组性别、BMI、TC、LDL-C水平差异无统计学意义(P>0.05);年龄、FBG、Scr、TG、mALb、UACR、HbAlc、Betatrophin为DKD2>DKD1>DKD0>NC(P<0.05);eGFR、HDL-C为NC>DKD0>DKD1>DKD2(P<0.05);2型糖尿病肾脏病患者血清中Betatrophin表达水平与年龄、UREA、Scr、mAlb、UACR呈正相关关系,与eGFR呈负相关关系,HbA1c表达与FBG、TC呈正相关关系,与Scr、eGFR呈负相关(P<0.05);患者年龄、FBG、TG、UREA、Scr、UACR、HbAlc、Betatrophin水平升高是2型DKD发生的危险因素,HDL-C、eGFR是2型糖尿病肾脏病发生的保护因素(P<0.05);HbA1c、Betatrophin联合检测的敏感性和特异性较单一检测高,HbA1c、Betatrophin及联合检测曲线下面积分别为0.713、0.860、0.887。结论:HbA1c、Betatrophin表达水平与早期DKD发生、发展密切相关,可作为早期DKD诊断的重要生物学指标,两者联合检测可提高早期糖尿病肾脏病的诊断效能。Objective:To explore the relationship between HbA1c,betatrophin level and renal function in patients with type 2 diabetes,aiming to provide laboratory reference for the early diagnosis and grading,treatment and prognosis evaluation of DKD.Methods:A retrospective analysis was performed on 90 patients with type 2 diabetes mellitus(T2DM)who were hospitalized in the endocrinology Department of our hospital from October 2021 to June 2022.According to the ratio of microalbuminuria to creatinine(ACR),the patients were divided into normal albuminuria group,microalbuminuria group and large albuminuria group,30 cases each.In the same period,30 healthy subjects were randomly selected as control group.The correlation between HbA1c and Betatrophin and the above indexes was analyzed.The application value of HbA1c and Betatrophin combined detection in DKD diagnosis was analyzed by Logistic regression and ROC curve.Results:There were no significant differences in gender,BMI,TC and LDL-C among the four groups(P>0.05).Age,FBG,Scr,TG,mAlb,UACR,HbAlc,Betatrophin were DKD2>DKD1>DKD0>NC(P<0.05).EGFR and HDL-C were NC>DKD0>DKD1>DKD2(P<0.05).Serum Betatrophin expression level was positively correlated with age,UREA,Scr,mAlb and UACR,and negatively correlated with eGFR,HbA1c expression was positively correlated with FBG and TC,and negatively correlated with Scrand eGFR(P<0.05).Age,FBG,TG,UREA,Scr,UACR,HbAlc and Betatrophin levels were risk factors for type 2 diabetic kidney disease,and HDL-C and eGFR were protective factors for type 2 diabetic kidney disease(P<0.05).The combined detection of HbA1c and Betatrophin showed higher specificity and specificity than the single detection.The areas under HbA1c,Betatrophin and combined detection curves were 0.713,0.860 and 0.887,respectively.Conclusion:The expression levels of HbA1c and Betatrophin which can be used as important biological indicators for the diagnosis of early diabetic nephropathy are closely related to the occurrence and development of early diabetic nephropathy,the united detect

关 键 词：HBA1C Betatrophin 2型糖尿病 糖尿病肾脏疾病 

分 类 号：R692[医药卫生—泌尿科学] R587.2[医药卫生—外科学]