尿液和血清水通道蛋白5与糖尿病肾病的肾功能快速进展风险的相关性研究  

Correlation of urinary and serum aquaporin 5 levels with the risk of rapid progression of renal function in patients with diabetic nephropathy

作　　者：张海祥 再努尔·买合木提 张奕 詹雯雯 Zhang Haixiang;ZaiNuer·Maihemuti;Zhang Yi;Zhan Wenwen(Department of General Medical,the Seventh Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Department of Pharmacy,the Seventh Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第七附属医院全科医学科,乌鲁木齐830000 [2]新疆医科大学第七附属医院药学部,乌鲁木齐830000

出　　处：《国际泌尿系统杂志》2025年第1期112-116,共5页International Journal of Urology and Nephrology

基　　金：新疆医科大学第七附属医院院内科研基金项目(2022YZR-02)。

摘　　要：目的探讨尿液和血清水通道蛋白5(AQP5)水平与糖尿病肾病(DN)患者肾功能快速进展的相关性。方法选取2021年1月至2022年3月在本院就诊的522例DN患者的临床资料,收集患者的临床基线资料,检测患者的血脂[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]、空腹血糖(FPG)、血尿素氮(BUN)、血肌酐(Scr)、估算肾小球滤过率(eGFR)水平;采用酶联免疫法检测患者血清中AQP5水平,采用放射免疫法检测尿液中AQP5水平。随访1年,以eGFR下降>5 mL·(min·1.73 m^(2))^(-1)为标准将患者分为进展组(55例)和对照组(455例),对比两组患者的临床实验室资料,采用logistic回归分析影响DN患者肾功能进展的独立相关因素,采用Pearson相关性分析AQP5水平与eGFR的相关性。结果进展组的年龄、糖尿病视网膜病变(DR)比例、收缩压(SBP)、Scr、血清AQP5、尿液AQP5水平高于对照组,差异均有统计学意义(均P<0.05)。末次随访时,510例患者的eGFR水平为(42.71±9.85)mL·(min·1.73 m^(2))^(-1),Pearson相关性分析结果显示尿液AQP5、血清AQP5与末次随访eGFR水平呈负相关(r=0.694、0.166,均P<0.05)。logistic回归分析结果显示,高龄、高Scr、DR、SBP及尿液AQP5水平是DN患者肾功能快速进展的独立危险因素(均P<0.05)。限制性立方样条图结果显示,尿液AQP5水平与DN患者肾功能快速进展呈线性关系(非线性χ^(2)=2.070,P=0.355)。结论尿液中AQP5是DN患者肾功能进展的独立相关因素,可以作为临床上早期识别DN患者肾功能快速进展的新标志物。Objective To investigate the correlation between urinary and serum aquaporin 5(AQP5)levels and rapid renal function progression in diabetic nephropathy(DN)patients.Methods Clinical data of 522 patients with DN in our hospital from January 2021 to March 2022 were selected,and clinical baseline data were collected.Blood lipids[triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)],fasting blood glucose(FPG),blood urea nitrogen(BUN),blood creatinine(Scr),and estimated glomerular filtration rate(eGFR)levels were measured.Serum AQP5 levels were detected by enzyme-linked immunoassay and urine AQP5 levels were detected by radioimmunoassay.At 1-year follow-up,patients were divided into a progressive group(55 cases)and a control group(455 cases)according to eGFR decline>5 mL·(min·1.73 m^(2))^(-1).The clinical laboratory data of the two groups were compared,and the independent correlation factors of renal function progression in patients with DN were analyzed by logistic regression.Pearson correlation was used to analyze the correlation between AQP5 level and eGFR.Results The levels of age,DR Proportion,SBP,Scr,serum AQP5 and urine AQP5 in the progressive group were higher than those in the control group,with statistical significance(all P<0.05).At the last follow-up,eGFR levels of 510 patients were(42.71±9.85)mL·(min·1.73 m^(2))^(-1).Pearson correlation analysis showed that urine AQP5 and serum AQP5 were negatively correlated with eGFR levels at the last follow-up(r=0.694,0.166,all P<0.05).Logistic regression analysis showed that old age,high Scr,diabetic retinopathy(DR),systolic blood presswe(SBP)and urine AQP5 levels were independent risk factors for rapid renal function progression in DN patients(all P<0.05).The results of restricted cubic spline plots showed a significant linear relationship between urine AQP5 level and rapid renal function progression in DN patients(nonlinearχ^(2)=2.070,P=0.355).Conclusions AQP5 in urine is an independent correlation factor for rapid renal function p

关 键 词：糖尿病肾病 水通道蛋白5 肾功能 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]