血清SFRP5、FGF-21、KIM-1联合检测对糖尿病肾病的诊断价值  

Diagnostic value of combined detection of serum SFRP5,FGF-21,and KIM-1 in for diabetic nephropathy

作　　者：曹冰 龚燕红 张萌萌[2] 邵松 黄玉庭 CAO Bing;GONG Yanhong;ZHANG Mengmeng;SHAO Song;HUANG Yuting(Department of Clinical Laboratory,Jingnan Medical District,General Hospital of the People′s Liberation Army,Beijing 100843,China;Department of Internal Medicine,Jingnan Medical District,General Hospital of the People′s Liberation Army,Beijing 100843,China;Department of Medical Imaging,Jingnan Medical District,General Hospital of the People′s Liberation Army,Beijing 100843,China;Department of Clinical Laboratory,Laibin People′s Hospital,Laibin,Guangxi 546100,China)

机构地区：[1]解放军总医院京南医疗区检验科,北京100843 [2]解放军总医院京南医疗区内科,北京100843 [3]解放军总医院京南医疗区医学影像科,北京100843 [4]来宾市人民医院检验科,广西来宾546100

出　　处：《国际检验医学杂志》2025年第6期738-741,747,共5页International Journal of Laboratory Medicine

基　　金：2022年度自治区卫生健康委自筹经费科研课题项目(Z-G20221781)。

摘　　要：目的探讨血清分泌型卷曲相关蛋白-5(SFRP5)、成纤维细胞生长因子-21(FGF-21)、肾损伤分子-1(KIM-1)联合检测对糖尿病肾病(DN)的诊断价值。方法选取2021年12月至2023年12月于解放军总医院京南医疗区接受治疗的DN患者(n=53)作为研究组,另选取单纯糖尿病患者(n=53)为对照组。采用酶联免疫吸附试验检测血清SFRP5、FGF-21、KIM-1水平,采用多因素Logistic回归分析影响DN发生的因素,绘制受试者工作特征(ROC)曲线分析血清SFRP5、FGF-21、KIM-1水平联合诊断DN发生的效能。结果与对照组比较,研究组空腹血糖、尿白蛋白/尿肌酐、尿微量白蛋白、FGF-21、KIM-1水平明显升高(P<0.05),肾小球滤过率、SFRP5水平明显降低(P<0.05)。血清SFRP5、FGF-21、KIM-1联合诊断DN发生的曲线下面积(AUC)为0.977,大于各指标单独诊断(Z_(三者联合-SFRP5)=2.759、P=0.006,Z_(三者联合-FGF-21)=2.936、P=0.003,Z_(三者联合-KIM-1)=3.104、P=0.002),联合诊断的灵敏度为96.23%,特异度为88.68%,约登指数为0.849。SFRP5、FGF-21、KIM-1、空腹血糖、肾小球滤过率、尿白蛋白/尿肌酐、尿微量白蛋白均是影响DN发生的因素(P<0.05)。结论DN患者血清SFRP5水平降低,FGF-21、KIM-1水平升高,三者联合诊断DN发生的效能最好。Objective To investigate the diagnostic value of combined detection of serum secreted frizzled-related protein 5(SFRP5),fibroblast growth factor-21(FGF-21)and kidney injury molecule-1(KIM-1)in diabetic nephropathy(DN).Methods Patients with DN(n=53)who were treated in Jingnan Medical District,General Hospital of the People′s Liberation Army from December 2021 to December 2023 were selected as the study group,and patients with simple diabetes(n=53)were selected as the control group.The levels of serum SFRP5,FGF-21 and KIM-1 were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was used to analyze the factors affecting the occurrence of DN.The receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of serum SFRP5,FGF-21 and KIM-1 levels in the diagnosis of occurrence of DN.Results Compared with the control group,the levels of fasting blood glucose,urine albumin/urine creatinine,urine microalbumin,FGF-21 and KIM-1 in the study group were significantly increased(P<0.05),while the levels of glomerular filtration rate and SFRP5 were significantly decreased(P<0.05).The area under the curve(AUC)of serum SFRP5,FGF-21 and KIM-1 in the diagnosis of occurrence of DN was 0.977,which was larger than that of each index alone(Z_(three combination-SFRP5)=2.759,P=0.006,Z_(three combination-FGF-21)=2.936,P=0.003,Z_(three combination-KIM-1)=3.104,P=0.002).The sensitivity of combined diagnosis was 96.23%,the specificity was 88.68%,and the Youden index was 0.849.SFRP5,FGF-21,KIM-1,fasting blood glucose,glomerular filtration rate,urine albumin/urine creatinine,urine microalbumin were the influencing factors of occurrence of DN(P<0.05).Conclusion The serum SFRP5 level is decreased and FGF-21 and KIM-1 levels are increased in DN patients.The combination of the three has the best diagnostic efficiency for occurrence of DN.

关 键 词：分泌型卷曲相关蛋白-5 成纤维细胞生长因子-21 肾损伤分子-1 糖尿病肾病 诊断 

分 类 号：R587.2[医药卫生—内分泌]