KIM1、TIMP2及炎症指标与2型糖尿病肾病进展风险的相关性研究  

Correlation of KIM1,TIMP2,and inflammatory markers with the risk of progression of type 2 diabetic nephropathy

作　　者：孙小芳 尹丽明 包利文 廖智威 付文金 王少波 SUN Xiao-fang;YIN Li-ming;BAO Li-wen;LIAO Zhi-wei;FU Wen-jin;WANG Shao-bo(Department of Endocrinology,Houjie Clinical Medical College,Guangdong Medical University,Dongguan 523960,Guangdong,CHINA;Department of Clinical Laboratory,Houjie Clinical Medical College,Guangdong Medical University,Dongguan 523960,Guangdong,CHINA)

机构地区：[1]广东医科大学厚街临床医学院内分泌科,广东东莞523960 [2]广东医科大学厚街临床医学院检验科,广东东莞523960

出　　处：《海南医学》2024年第14期2036-2041,共6页Hainan Medical Journal

基　　金：广东省东莞市社会发展科技重点项目(编号:20221800905852)。

摘　　要：目的检测不同程度肾脏疾病的糖尿病患者中血清肾损伤分子-1(KIM-1)、金属基质蛋白酶抑制剂-2(TIMP2)、白介素6(IL-6)和C反应蛋白(CRP)的水平,并评估其与糖尿病肾脏进展风险的关系。方法选取2022年3月至2023年3月东莞厚街医院收治的65例2型糖尿病患者纳入研究,根据患者肾脏病变的严重程度,按照改善全球预后指南将糖尿病肾病(DKD)分为低风险组(n=19)、中风险组(n=22)和高风险组(n=24),同期选择20例体检健康者作为对照组。比较各组受试者血清KIM-1、TIMP-2、IL-6、CRP、糖化血红蛋白(HbAlc)、尿蛋白/肌酐比值(UACR)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、血清总胆固醇(TC)、肾小球滤过率(eGFR)、高密度脂蛋白胆固醇(HDL-C)、25羟维生素D_(3)[(25(OH)D_(3))]和甘油三酯(TG)的水平,采用Pearson法分析血清TIMP-2、KIM-1与DKD糖脂代谢、肾功能指标的相关性,利用受试者工作(ROC)曲线分析血清KIM-1、TIMP-2、IL-6、CRP、KIM-1与TIMP-2联合检测对DKD疾病进展的预测价值。结果四组受检者血清LDL-C、HDL-C和CRP水平比较差异均无统计学意义(P>0.05);对照组血清FPG、HbAlc、TIMP2、KIM-1水平分别为(5.13±0.56)mmol/L、(5.56±0.30)%、(4.91±0.76)ng/mL、(0.46±0.33)ng/mL,明显低于低风险组的(12.17±9.82)mmol/L、(9.45±2.46)%、(11.51±25.01)ng/mL、(1.00±0.68)ng/mL及中风险组的(11.35±10.63)mmol/L、(9.73±2.82)%、(30.23±17.42)ng/mL、(1.26±1.31)ng/mL和高风险组的(8.04±7.69)mmol/L、(9.27±2.21)%、(30.51±46.01)ng/mL、(1.63±1.09)ng/mL,而低风险组的血清中TIMP2、KIM-1水平明显低于中风险组、高风险组,差异均有统计学意义(P<0.05);高风险组患者的血清CREA、IL-6水平分别为(122.00±79.23)μmmol/L、(3.51±5.92)pg/mL,明显高于低风险组的(77.00±42.70)μmmol/L、(0.50±2.79)pg/mL和中风险组的(74.00±32.25)μmmol/L、(1.34±3.61)pg/mL,差异均有统计学意义(P<0.05);经Spearman相关分析结果显示2型糖尿�Objective To measure the levels of blood clear kidney injury molecule-1(KIM-1),metallomatrix protease inhibitor-2(TIMP2),interleukin 6(IL-6),and C-reactive protein(CRP)in diabetic patients with different degrees of kidney disease,and to evaluate their relationship with the risk of progression of diabetic kidney disease(DKD).Methods A total of 65 patients with type 2 diabetes who were admitted to Dongguan Houjie Hospital from March 2022 to March 2023 were selected for inclusion in the study.Based on the severity of renal lesions,the patients were divided into low-risk group(n=19),medium-risk group(n=22),and high-risk group(n=24)according to the Kidney Disease:Improving Global Outcomes(KDIGO),and 20 healthy patients during the same period were selected as the control group.The blood levels of KIM-1,TIMP-2,IL-6,CRP,glycosylated hemoglobin(HbAlc),urine albumin-to-creatinine ratio(UACR),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FPG),serum total cholesterol(TC),estimated glomerular filtration rate(eGFR),high-density lipoprotein cholesterol(HDL-C),25-hydroxyvitamin D_(3)[25(OH)D_(3)]and triglycerides(TG)were compared among the four groups.Pearson method was used to analyze the correlation of serum TIMP-2,KIM-1 with DKD glucose and lipid metabolism and renal function indexes.Receiver operating curve(ROC)was used to analyze the predictive value of serum KIM-1,TIMP-2,IL-6,CRP,and KIM-1 combined with TIMP-2 for DKD progression.Results There were no significant differences in the levels of serum LDL-C,HDL-C,and CRP among the four groups(P>0.05).The serum levels of FPG,HbAlc,TIMP-2,and KIM-1 in the control group were(5.13±0.56)mmol/L,(5.56±0.30)%,(4.91±0.76)ng/mL,and(0.46±0.33)ng/mL,respectively,significantly lower than(12.17±9.82)mmol/L,(9.45±2.46)%,(11.51±25.01)ng/mL,(1.00±0.68)ng/mL in low-risk group and(11.35±10.63)mmol/L,(9.73±2.82)%,(30.23±17.42)ng/mL,(1.26±1.31)ng/mL in medium-risk group,and(8.04±7.69)mmol/L,(9.27±2.21)%,(30.51±46.01)ng/mL,(1.63±1.09)ng/mL in high-risk group,respe

关 键 词：糖尿病肾病 肾损伤分子-1 金属基质蛋白酶抑制剂-2 炎症因子 相关性 

分 类 号：R587.2[医药卫生—内分泌]