2型糖尿病患者血清人附睾蛋白4与蛋白尿的相关性研究  

Correlation between serum human epididymis protein 4 levels and proteinuria in type 2 diabetes patients

作　　者：薄春燕[1] 张仕佩 楚金申[2] 薛国辉[2] 万芳[3] 曹俊达 陈可奇 陈静 刘晓峰[2] 陈雪礼[2] BO Chunyan;ZHANG Shipei;CHU Jinshen;XUE Guohui;WAN Fang;CAO Junda;CHEN Keqi;CHEN Jing;LIU Xiaofeng;CHEN Xueli(Department of Nutrition,Jiujiang NO.1 People’s Hospital,Jiujiang 332000,Jiangxi,China;Department of Clinical Laboratory,Jiujiang NO.1 People’s Hospital,Jiujiang 332000,Jiangxi,China;Department of Endocrinology,Jiujiang NO.1 People’s Hospital,Jiujiang 332000,Jiangxi,China;Department of Cardiology,Jiujiang NO.1 People’s Hospital,Jiujiang 332000,Jiangxi,China)

机构地区：[1]九江市第一人民医院营养科,江西九江332000 [2]九江市第一人民医院检验科,江西九江332000 [3]九江市第一人民医院内分泌科,江西九江332000 [4]九江市第一人民医院心血管内科,江西九江332000

出　　处：《中国现代医生》2024年第33期1-5,共5页China Modern Doctor

基　　金：江西省卫生健康委科技计划项目(202211864)。

摘　　要：目的探讨人附睾蛋白4(human epididymis protein 4,HE4)与2型糖尿病(type 2 diabetes mellitus,T2DM)患者蛋白尿的相关性。方法选取2020年1月至2023年7月九江市第一人民医院收治的147例T2DM患者作为观察组,根据蛋白尿严重程度将观察组分为正常白蛋白尿组(101例)、微量白蛋白尿组(25例)、大量白蛋白尿组(21例);同期选取性别、年龄相匹配的50名健康体检者作为对照组。比较分析各组纳入者的HE4和临床指标变化,采用单因素和多因素线性回归分析探讨HE4与蛋白尿的相关性。结果相关性网络图显示HE4是连接血液白蛋白、尿微量白蛋白、尿微量白蛋白/尿肌酐(urinary microalbumin-to-creatinine ratio,UACR)及肾脏功能生物标志物的一个重要节点;与对照组比较,观察组患者的HE4水平显著升高(P<0.01),单因素和多因素线性回归分析均显示HE4与UACR呈正相关;Logistic回归结果显示校正年龄、性别、估算肾小球滤过率(estimated glomerular filtration rate,e GFR)、白蛋白(albumin,ALB)、血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,SCr)、尿酸(uricacid,UA)、乳酸脱氢酶(actate dehydrogenase,LDH)等混杂因素后,HE4水平升高是蛋白尿发生的危险因素(OR=1.110,95%CI:1.005~1.226)。结论HE4与UACR呈正相关,其水平升高可增加T2DM患者的蛋白尿发生风险。Objective To investigate the correlation of human epididymis protein 4(HE4)with proteinuria in patients with type 2 diabetes mellitus(T2DM).Methods A total of 147 T2DM patients from January 2020 to July 2023 in Jiujiang NO.1 People’s Hospital were enrolled in observation group.According to the severity of proteinuria,observation group was divided into three groups:Normal albuminuria group(101 cases),microalbuminuria group(25 cases),and massive albuminuria group(21 cases).50 healthy examinees with gender and age matching during the same period were selected as control group.HE4 levels and clinical indicators in each group were compared and analyzed.Correlation between HE4 and proteinuria was analyzed by using univariate and multivariate linear regression.Results The correlation network diagram reveals that HE4 functions was a pivotal node linking serum albumin,urinary microalbumin,urinary microalbumin-to-creatinine ratio(UACR),and renal function biomarkers.Compared to control group,HE4 levels significantly elevated in observation group(P<0.01).Both univariate and multivariate linear regression analysis demonstrate a positive correlation between HE4 and UACR.Logistic regression analysis shew that after adjusting for confounding factors including age,gender,estimated glomerular filtration rate(eGFR),albumin(ALB),blood urea nitrogen(BUN),serum creatinine(SCr),uric acid(UA),lactate dehydrogenase(LDH)etc.elevated HE4 levels was a risk factor for proteinuria(OR=1.110,95%CI:1.005-1.226).Conclusion Elevated HE4 levels in patients with T2DM is positivly correlated with UACR.Increase its level increases the risk of proteinuria in T2DM patients.

关 键 词：蛋白尿 人附睾蛋白4 2型糖尿病 糖尿病肾病 

分 类 号：R587.2[医药卫生—内分泌]