肝纤维化-4指数与维生素D_(3)水平对糖尿病肾病进展风险的预测价值  

Predictive value of liver fibrosis index-4 and level of vitamin D_(3)on the progression risk in diabetes nephropathy

作　　者：师帅[1] 田宇[2] 赵伊婷[3] 李敏[4] SHI Shuai;TIAN Yu;ZHAO Yiting;LI Min(Department of Rheumatology and Nephrology,the Sixth Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi830000,China;Department of Gastroenterology,the Sixth Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi830000,China;Department of Laboratory,the Sixth Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi830000,China;Department of Endocrinology,the Sixth Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi830000,China)

机构地区：[1]新疆医科大学第六附属医院风湿肾病科,新疆乌鲁木齐830000 [2]新疆医科大学第六附属医院消化科,新疆乌鲁木齐830000 [3]新疆医科大学第六附属医院检验科,新疆乌鲁木齐830000 [4]新疆医科大学第六附属医院内分泌科,新疆乌鲁木齐830000

出　　处：《中国医药导报》2024年第28期37-41,共5页China Medical Herald

基　　金：新疆维吾尔自治区自然科学基金项目(2020D01A128)。

摘　　要：目的探讨肝纤维化-4指数(FIB-4)与维生素D_(3)水平对糖尿病肾病(DN)进展风险的预测价值。方法选取2020年1月至2023年10月于新疆医科大学第六附属医院就诊的262例DN患者作为研究对象,采用FIB-4评估肝纤维化,检测25-羟基维生素D_(3)[25(OH)D_(3)]水平。根据DN进展情况,将其分为进展组(84例)和对照组(178例)。比较两组一般资料。采用logistic回归分析DN进展的影响因素。采用受试者操作特征(ROC)曲线分析FIB-4和25(OH)D_(3)水平对DN进展风险的预测价值。根据25(OH)D_(3)水平的中位数,将患者分为低25(OH)D_(3)水平组(≤12.96μg/L,132例)和高25(OH)D_(3)水平组(>12.96μg/L,130例),比较两组血清白细胞介素-1(IL-1)和C反应蛋白(CRP)水平。结果进展组DN患者肌酐、24 h尿蛋白定量、FIB-4水平高于对照组,25(OH)D_(3)水平低于对照组(P<0.05)。logistic回归分析显示,肌酐(OR=1.071)、24 h尿蛋白定量(OR=17.365)、FIB-4(OR=26.982)和25(OH)D_(3)水平(OR=0.648)均是DN进展风险的影响因素(P<0.05)。ROC曲线结果显示,FIB-4和25(OH)D_(3)水平预测DN进展风险的曲线下面积分别为0.799(截断值为2.055,敏感度为64.3%,特异度为90.4%)和0.815(截断值为13.25μg/L,敏感度为89.3%,特异度为64.0%)。低25(OH)D_(3)水平组IL-1和CRP水平均高于高25(OH)D_(3)水平组(P<0.05)。结论高FIB-4水平和低25(OH)D_(3)水平是DN进展风险的危险因素,二者对DN进展风险具有较高的预测价值。Objective To study the predictive value of liver fibrosis index-4(FIB-4)and level of vitamin D_(3)on the progression risk in diabetes nephropathy(DN).Methods A total of 262 DN patients who visited the Sixth Affiliated Hospital of Xinjiang Medical University from January 2020 to October 2023 were selected as the study subjects.FIB-4 was used to evaluate liver fibrosis and levels of 25-hydroxyvitamin D_(3)(25[OH]D_(3))were detected.Patients were divided into the progression group(84 cases)and the control group(178 cases)based on the progression status of DN.Data were compared between the two groups.Logistic regression was used to analyze the influencing factors of DN progression.The predictive value of FIB-4 and 25(OH)D_(3)level on DN progression risk was analyzed by receiver operation characteristic(ROC)curve.According to the median of 25(OH)D_(3)level,patients were divided into the low 25(OH)D_(3)level group(≤12.96μg/L,132 cases)and the high 25(OH)D_(3)level group(>12.96μg/L,130 cases).Serum levels of interleukin-1(IL-1)and C-reactive protein(CRP)were compared between the two groups.Results The levels of creatinine,24-hour urine protein quantification,and FIB-4 in DN patients in the progression group were higher than those in the control group,while the levels of 25(OH)D_(3)were lower than those in the control group(P<0.05).Logistic regression analysis showed that creatinine(OR=1.071),24-hour urine protein quantification(OR=17.365),FIB-4(OR=26.982),and 25(OH)D_(3)levels(OR=0.648)were influencing factors for the DN progression risk(P<0.05).ROC curve result showed that the area under the curve of FIB-4 and 25(OH)D_(3)levels for predicting DN progression risk were 0.799(cut-off value≥2.055,sensitivity 64.3%,specificity 90.4%)and 0.815(cut-off value 13.25μg/L,sensitivity 89.3%,specificity 64.0%)respectively.The levels of IL-1 and CRP in the low 25(OH)D_(3)level group were higher than those in the high 25(OH)D_(3)level group(P<0.05).Conclusion High FIB-4 levels and low 25(OH)D_(3)levels are risk factors for DN

关 键 词：肝纤维化-4指数 维生素D 糖尿病肾病 疾病进展 预测 

分 类 号：R587.1[医药卫生—内分泌]