血清25-(OH)D_(3)、YKL-40联合对2型糖尿病患者尿路感染诊断价值的研究  

Diagnostic Value of Combination of Serum 25-(OH)D_(3) and YKL-40 for Urinary Tract Infection in Patients with Type 2 Diabetes Mellitus

作　　者：杨代豪 程华 袁权 Yang Daihao;Cheng Hua;Yuan Quan(Department of Urology,Chongqing Kaizhou Hospital of Traditional Chinese Medicine,Chongqing 405400,China)

机构地区：[1]重庆市开州区中医院泌尿外科,重庆405400

出　　处：《成都医学院学报》2025年第2期295-298,共4页Journal of Chengdu Medical College

基　　金：重庆市自然科学基金面上项目(No:CSTB2022NSCQ-MSX0796)。

摘　　要：目的 分析血清25-羟维生素D_(3)[25-(OH)D_(3)]、几丁质酶样蛋白40(YKL-40)联合检测对2型糖尿病患者尿路感染的诊断价值。方法 选取2021年1月至2024年1月在重庆市开州区中医院就诊的2型糖尿病患者(n=280),根据是否合并尿路感染分为合并组(n=92)和非合并组(n=188);另选取50例健康体检者为对照组。检测并比较血液指标和尿液指标;采用Logistic回归分析2型糖尿病患者合并尿路感染的影响因素;采用受试者工作特征(ROC)曲线分析血清25-(OH)D_(3)、YKL-40对2型糖尿病患者尿路感染的诊断价值。结果 非合并组与合并组的空腹血糖(FPG)、中性粒细胞计数(NEUT)、YKL-40和糖化血红蛋白(HbA1c)≥7%患者所占比例高于对照组,25-(OH)D_(3)低于对照组(P<0.05);合并组的FPG、NEUT、病程、YKL-40和HbA1c≥7%患者所占比例高于非合并组,25-(OH)D_(3)低于非合并组(P<0.05);高HbA1c、高YKL-40、低25-(OH)D_(3)是2型糖尿病患者合并尿路感染的危险因素(P<0.05);与血清25-(OH)D_(3)、YKL-40单独诊断2型糖尿病患者尿路感染的AUC(0.797、0.799)相比,联合诊断的AUC(0.906)更高(P<0.05)。结论 合并尿路感染的2型糖尿病患者血清25-(OH)D_(3)水平较低,YKL-40水平较高,血清25-(OH)D_(3)、YKL-40与HbA1c是患者尿路感染的影响因素,联合25-(OH)D_(3)、YKL-40检测可能用于诊断患尿路感染的2型糖尿病患者。Objective To analyze the diagnostic value of combined detection of serum 25 hydroxyvitamin D_(3)[25-(OH)D_(3)]and chitinase-like protein YKL-40 for urinary tract infection(UTI)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 280 patients with T2DM in Chongqing Kaizhou Hospital of Traditional Chinese Medicine from January 2021 to January 2024 were included.They were divided into a combined group(n=92)and a non-combined group(n=188)according to whether they were complicated with UTI.Another 50 healthy individuals were selected as the control group.Blood and urine indicators were detected and compared.Logistic regression was used to analyze the influencing factors of UTI in T2DM patients.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum 25-(OH)D_(3) and YKL-40 for UTI in T2DM patients.Results The fasting plasma glucose(FPG),neutrophil count(NEUT),YKL-40,and proportion of patients with glycosylated hemoglobin(HbA1c)≥7%in the non-combined and combined groups were higher than those in the control group,while 25-(OH)D_(3) was lower than that in the control group(P<0.05).The FPG,NEUT,disease course,YKL-40,and proportion of patients with HbA1c≥7%in the combined group were higher than those in the non-combined group,while 25-(OH)D_(3) was lower than that in the non-combined group(P<0.05).High HbA1c,high YKL-40 and low 25-(OH)D_(3) were risk factors for UTI in T2DM patients(P<0.05).The area under the curve(AUC)of the combined detection of serum 25-(OH)D_(3) and YKL-40 for UTI in T2DM patients was 0.906,which was higher than that of their single detection(0.797 and 0.799,respectively)(P<0.05).Conclusion T2DM patients with UTI have low level of serum 25-(OH)D_(3) but high level of YKL-40.Serum 25-(OH)D_(3),YKL-40 and HbA1c levels were risk factors for UTI in T2DM patients.The combined detection of serum 25-(OH)D_(3) and YKL-40 may be used for the diagnosis of UTI in T2DM patients.

关 键 词：2型糖尿病 尿路感染 25-羟维生素D_(3) 几丁质酶样蛋白40 

分 类 号：R587.1[医药卫生—内分泌]