血清Smad1与2型糖尿病肾功能的关联及对糖尿病肾病的预测效能  

Correlation between serum Smad1 and renal function in type 2 diabetes mellitus and its predictive effect on diabetes nephropathy

作　　者：王帅南 曹松真 王莹莹 WANG Shuainan;CAO Songzhen;WANG Yingying(Department of Endocrinology,Kaifeng Third People's Hospital,Kaifeng 475100,China)

机构地区：[1]开封市第三人民医院祥符区第一人民医院内分泌科,开封475100

出　　处：《华夏医学》2025年第1期58-63,共6页Acta Medicinae Sinica

基　　金：河南省医学科技攻关项目(LHGJ2021010310)。

摘　　要：目的分析血清Smad同源物1(Smad1)与2型糖尿病(T2DM)肾功能指标的相关性,及对糖尿病肾病(DN)的预测效能。方法选取128例T2DM患者,依据是否并发DN将入组患者分别列为DN组(38例)、非DN组(90例),检验血清Smad1等与肾功能指标的肾小球滤过率(eGFR)、尿蛋白(PRO)、血清肌酐(SCr)、血清尿素氮(BUN)之间的相关性;归纳T2DM继发DN的危险因素;验证Smad1对T2DM继发DN的预测效能。结果经Pearson相关性系数检验,血清Samd1与PRO、SCr、BUN正相关,与eGFR负相关(P<0.05);Logistic多因素回归分析结果显示,BMI指数、T2DM病程、合并高血压、HbA1c、eGFR、PRO、SCr、BUN、Smad为T2DM继发DN的危险因素;血清Samd1对T2DM继发DN的预测灵敏度、特异度分别为80.77%、80.25%(AUC>0.85)。结论超重、合并高血压且病程较长的T2DM患者会由于肾功能损伤、Smad1水平过高而继发DN,动态监测血清Smad1水平能实现对T2DM继发DN的早期预测。Objective To analyze the correlation between serum Smad homolog 1(Smad1)and renal function indexes of type 2 diabetes mellitus(T2DM),and the predictive efficacy of Smad homolog 1(Smad1)on diabetes nephropathy(DN).Methods 128 patients with T2DM were classified into the DN group(38 cases)and non DN group(90 cases)according to whether they were concurrent DN or not.Correlations between serum Smad1 and isorenal function indicators including glomerular filtration rate(eGFR),urinary protein(PRO),serum creatinine(SCr),and serum urea nitrogen(BUN)were testedmmarize the risk factors for diabetic nephropathy secondary to T2DM through logistic multiple regression analysis.Verify the predictive efficacy of Smad1 for diabetic nephropathy secondary to T2DM by plotting receiver operating characteristic(ROC)curves and observing offline area(AUC).Results Pearson correlation coefficient test showed that serum Samd1 was positively correlated with PRO,SCr,BUN,and negatively correlated with eGFR(P<0.05).Logistic multivariate regression analysis showed that BMI index,T2DM duration,hypertension,HbA1c,eGFR,PRO,SCr,BUN,and Smad were all T2DM.Risk factors for secondary DN.According to ROC curve validation,the sensitivity and specificity of serum Samd1 for predicting DN secondary to T2DM were 80.77[FGS]%[FGN]and 80.25[FGS]%[FGN],respectively(AUC>0.85).Conclusion Overweight,hypertensive,and long-term T2DM patients may develop DN due to renal dysfunction and elevated levels of Smad1.Dynamic monitoring of serum Smad1 levels can achieve early prediction of DN secondary to T2DM.

关 键 词：2型糖尿病 肾功能损伤 糖尿病肾病 危险因素 Smad同源物1 

分 类 号：R58[医药卫生—内分泌]