尿N-乙酰β-D-氨基葡萄糖苷酶、血清胱抑素C在儿童单纯性肥胖肾脏早期损害的临床价值  

Clinical value of urinary NAC and scrum Cys-C in early renal damage of simple obesity in children

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作  者:王晓艳 华敏 王凤云[1] 谢蓉蓉[1] 陈临琪[1] 陈秀丽[1] 陈婷[1] 孙辉[1] 张丹丹 王莉莉 吴海瑛[1] WANG Xiao-yan;HUA Min;WANG Feng-yun(Department of Endocrinology,Genetics and Metabolism,Children's Hospital,Soochow University,Suzhou 215003,China)

机构地区:[1]苏州大学附属儿童医院内分泌遗传代谢科,江苏苏州215003

出  处:《中国实用儿科杂志》2025年第2期126-135,共10页Chinese Journal of Practical Pediatrics

基  金:苏州市科技发展计划(SKYD2023130)。

摘  要:目的探究尿N-乙酰β-D-氨基葡萄糖苷酶(urine N-acetyl-β-D-glucosaninidase,uNAG)和血清胱抑素C(cytatin-C,Cys-C)在单纯性肥胖儿童肾脏早期损害评估中的临床价值。方法选取2021年10月至2024年1月苏州大学附属儿童医院内分泌遗传代谢科确诊302例单纯性肥胖儿童,与同期年龄相仿53例儿童为正常对照组,留取两组人群临床资料,包括基础资料,血液及尿液检查结果,比较肥胖不同病程和正常对照组的临床资料的差异性,分析血清Cys-C、尿NAG和肾功能的相关性。将单纯性肥胖儿童按照尿微量白蛋白/尿肌酐(urmie albumin creatine raio,UACR)分为白蛋白尿组和无白蛋白尿组,比较两组的一般临床资料、实验室检查参数的差异性。采用多变量Logistie回归分析找出肾脏损害的预测指标。结果肥胖白蛋白尿组和肥胖无白蛋白尿组在总胆固醇(total cholesterol,TC)、甘油三酯(tigyeride,TC)、三酰甘油葡萄糖指数(riglyceride-glucose index,TyG)差异有统计学意义(P<0.05),在尿微量白蛋白(race albumin in urine,mALB)、uNAG、UACR差异有统计学意义(P<0.01)。肥胖白蛋白尿组中的uNAG与mALB、UACR呈中度正相关,与β2微球蛋白(β2-Micrnglobulin,β2M)呈中度负相关。uNAC是单纯性肥胖儿童肾脏早期损伤的独立影响因素。uNAG和血清Cys-C联合检测时ROC曲线下面积最大,特异度、敏感度均较高。结论单纯性肥胖儿童可能发生肾脏的早期损害。uNAG是单纯性肥胖儿童肾脏早期损伤的独立影响因素。uNAG和血清Cys-C联合在评估单纯性肥胖儿童肾脏早期损害均有一定价值。Objective To investigate the clinical value of urine N-acetyl-β-D-glucosaminidase(uNAG)and serum cystatin-C(Cys-C)in the assessment of early renal damage in children with simple obesity.Methods A total of 302 children with simple obesity were selected,who were diagnosed in the Department of Endocrinology,Genetics and Metabolism of Children's Hospital of Soochow University from October 2021 to January 2024,and 53 children of similar age in the same period were selected as the normal control group.The clinical data of the two groups were collected,including basic data,blood and urine test results,compare the differences in clinical data of different stages of obesity and normal control group.Analyze the correlation between serum Cys-C,urine NAG,and kidney function.Compare simple obesity group based on their urnie albumin creatine raio(UACR),dividing them into an albuminuria group and a normal albuminuria group.Examine the differences in general clinical data and laboratory parameters between these two subgroups.Multivariate Logistic regression analysis was used to identify the predictors of renal damage.Results There were statistically significant differences in total cholesterol(TC),triglyceride(TG)and triglyceride-glucose index(TyG)between the obese albuminuria group and the obese no-albuminuria group(P<0.05),and there were significant differences inβ2-microglobulin(mALB),uNAG and UACR(P<0.05).In the obese albuminuria group,uNAG was moderately positively correlated with mALB and UACR,and moderately negatively correlated withβ2M.uNAG was an independent influencing factor for early renal damage in children with simple obesity.The area under the ROC curve was the largest in the combined detection of uNAG and serum Cys-C,and the specificity and sensitivity were relatively high.Conclusion The children with simple obesity may have early kidney damage.uNAG is an independent influencing factor for early renal damage in children with simple obesity.The combination of uNAG,uNAG and serum Cys-C has certain value in the e

关 键 词:儿童单纯性肥胖 尿N-乙酰β-D-氨基葡萄糖苷酶 肥胖相关性肾损伤 

分 类 号:R72[医药卫生—儿科]

 

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