硫酸乙酰肝素和多配体蛋白聚糖1在早期糖尿病肾病诊断中的应用研究  

Application research of heparan sulfate and syndecan-1 in the diagnosis of early diabetic nephropathy

作　　者：谢丽倩[1] 张莉 张婷 罗亚维 蒋丽琼[3] Xie Liqian;Zhang Li;Zhang Ting;Luo Yawei;Jiang Liqiong(The First Affiliated Hospital of Suzhou University,key Laboratory of Thrombosis and Hemostasis of the National Health Commission,Suzhou 215001,China;Department of Medical Laboratory Center,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou Municipal Hospital,Suzhou 215001,China;Department of Nephrology,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou Municipal Hospital,Suzhou 215001,China)

机构地区：[1]苏州大学附属第一医院,国家卫生健康委员会血栓与止血重点实验室,江苏苏州215001 [2]南京医科大学附属苏州医院,苏州市立医院医学检验中心,江苏苏州215001 [3]南京医科大学附属苏州医院,苏州市立医院肾内科,江苏苏州215001

出　　处：《实用药物与临床》2024年第12期899-904,共6页Practical Pharmacy and Clinical Remedies

基　　金：苏州市肾脏病学重点学科项目(Szxk201807)。

摘　　要：目的 探讨血清硫酸乙酰肝素(HS)、多配体蛋白聚糖1(SCD-1)在早期糖尿病肾病中的诊断价值。方法 选取2020年10月至2022年10月南京医科大学附属苏州医院(苏州市立医院)收治的2型糖尿病(T2DM)患者199例,按照尿白蛋白/肌酐比值(UACR),分为单纯糖尿病组(DM组,UACR<30 mg/g,n=95)和早期糖尿病肾病组(DN组,30 mg/g≤UACR<300 mg/g,n=104)。收集所有患者血清,通过ELISA试验检测血清HS、SCD-1浓度,同时采集患者一般数据和实验室检查结果。统计分析两组患者间HS、SCD-1及其他实验室指标之间的差异,探讨上述物质对早期糖尿病肾病的预测价值。结果 (1)DN组患者血清HS、SCD-1水平均高于DM组,差异有统计学意义(P<0.05)。(2)多因素Logistic回归分析结果表明,HS、SCD-1和C反应蛋白(CRP)是早期糖尿病肾病的危险因素(P<0.05)。(3)ROC曲线评估危险因素诊断早期糖尿病肾病的效能,表明HS、SCD-1、CRP及联合预测的曲线下面积(Area under the curve,AUC)分别为0.708、0.628、0.696和0.773(P<0.05);ROC曲线评估危险因素预测早期糖尿病肾病组患者合并较高水平UACR的效能,SCD-1和血清肌酐倒数(1/肌酐)的AUC分别为0.773、0.661(P<0.05)。结论 升高的血清HS、SCD-1可能是早期糖尿病肾病的生物标志物,升高的SCD-1和降低的肌酐水平可较好地预测早期糖尿病肾病患者尿微量白蛋白的高排泄率,可能是糖尿病肾病进展的敏感预测因子。Objective To investigate the diagnostic significance of serum heparan sulfate(HS)and syndecan-1(SCD-1)in patients with early diabetic nephropathy.Methods A total of 199 patients with type 2 diabetes mellitus(T2DM)who admitted to the Affiliated Suzhou Hospital of Nanjing Medical University(Suzhou Municipal Hospital)from October 2020 to October 2022 were enrolled.According to the urinary albumin/creatinine ratio(UACR),all patients were divided into two groups:the simple diabetes mellitus group(DM group,patients with UACR<30 mg/g,n=95)and early diabetic nephropathy group(DN group,patients with UACR≥30 mg/g and<300 mg/g,n=104).The general data and laboratory test results of patients were collected,and serum HS and SCD-1 concentrations were detected by ELISA.The differences of serum HS,SCD-1 and other laboratory data between the two groups were analyzed to explore the predictive value of the above substances for early diabetic nephropathy.Results①The levels of serum HS and SCD-1 in DN group were higher than those in DM group(P<0.05).②Results of multivariate Logistic regression analysis showed that HS,SCD-1,and C-reactive protein(CRP)were the risk factors for early diabetic nephropathy(P<0.05).③ROC curve was used to evaluate the efficacy of the risk factors in diagnosing early diabetic nephropathy,and the results showed that the area under the curve(AUC)for HS,SCD-1,CRP,and joint prediction were 0.708,0.628,0.696,and 0.773,respectively(P<0.05);ROC curve was used to evaluate the efficacy of risk factors in predicting the presence of higher levels of UACR in early diabetic nephropathy patients.The AUC of SCD-1 and serum creatinine reciprocal(1/creatinine)were 0.773 and 0.661,respectively(P<0.05).Conclusion Elevated serum HS and SCD-1 may be biomarkers of early diabetic nephropathy.Elevated SCD-1 and reduced creatinine levels can well predict the high urine microalbumin excretion rate in patients with early diabetic nephropathy,and may be sensitive predictors ofdiabetic nephropathy progression .

关 键 词：硫酸乙酰肝素 多配体蛋白聚糖1 2型糖尿病 糖尿病肾病 

分 类 号：R692.9[医药卫生—泌尿科学] R587.2[医药卫生—外科学]