糖尿病视网膜病变患者血清NRG4、FABP4水平及其诊断价值  

Levels of serum NRG4 and FABP4 in patients with diabetes retinopathy and their diagnostic value

作　　者：马凯惠 褚光敏 张爱英 王停停 刘艳 MA Kaihui;CHU Guangmin;ZHANG Aiying;WANG Tingting;LIU Yan(Department of Clinical Laboratory,Endocrine and Metabolic Disease Hospital Affiliated to Shandong First Medical University,Jinan,Shandong 250000,China;Department of Blood Transfusion,Jinan Third People's Hospital,Jinan,Shandong 250132,China;Department of Clinical Laboratory,Eye Hospital Affiliated to Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250004,China)

机构地区：[1]山东第一医科大学附属内分泌与代谢病医院检验科,山东济南250000 [2]济南市第三人民医院输血科,山东济南250132 [3]山东中医药大学附属眼科医院检验科,山东济南250004

出　　处：《国际检验医学杂志》2025年第7期812-816,共5页International Journal of Laboratory Medicine

基　　金：山东省自然科学基金项目(ZR2017YL008)。

摘　　要：目的探讨糖尿病视网膜病变(DR)患者血清神经调节蛋白(NRG4)、血清脂肪酸结合蛋白(FABP4)水平及其诊断价值。方法选取2020年4月至2023年4月于山东第一医科大学附属内分泌与代谢病医院入院治疗的84例DR患者为观察组,依据患者的视网膜病变类型,将其分为增殖性病变组(35例)和非增殖性病变组(49例);另选取同期84例单纯糖尿病患者为NDR组,同期体检的健康者84例为对照组。采用酶联免疫吸附试验检测血清NRG4、FABP4水平;采用多因素Logistic回归分析DR发生的影响因素,受试者工作特征(ROC)曲线分析血清NRG4、FABP4水平对DR的诊断价值。结果观察组C反应蛋白(CRP)、空腹血糖(FPG)、空腹胰岛素(FINS)、FABP4水平高于NDR组和对照组(P<0.05),血清NRG4水平低于NDR组和对照组(P<0.05);增殖性病变组血清NRG4水平低于非增殖性病变组(P<0.05),FABP4水平高于非增殖性病变组(P<0.05);NRG4是发生DR的保护因素(P<0.05),FABP4是发生DR的危险因素(P<0.05);血清NRG4、FABP4诊断DR的曲线下面积(AUC)为0.850、0.866,联合诊断的AUC为0.930,二者联合优于血清NRG4、FABP4各自单独诊断(Z_(二者联合-NRG4)=3.467、Z_(二者联合-FABP4)=2.987,P=0.001、0.002)。结论DR患者血清FABP4水平明显上升,NRG4水平明显下降,二者联合对DR具有较高的诊断价值。Objective To investigate the levels of serum neuregulin-4(NRG4)and serum fatty acid binding protein 4(FABP4)in patients with diabetes retinopathy(DR)and their diagnostic value.Methods From April 2020 to April 2023,a total of 84 DR patients admitted to Endocrine and Metabolic Disease Hospital Affiliated to Shandong First Medical University were regarded as the observation group.Based on the type of retinal lesions,they were grouped into proliferative lesion group(35 cases)and non proliferative lesion group(49 cases).In addition,84 patients with simple diabetes in the same period were regarded as the NDR group,and 84 healthy people who underwent physical examination in the same period were regarded as the control group.Enzyme linked immunosorbent assay was applied to detect serum levels of NRG4 and FABP4.Multivariate Logistic regression was applied to analyze the influencing factors of DR occurrence.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum NRG4 and FABP4 levels for DR.Results The levels of C-reactive protein(CRP),fasting plasma glucose(FPG),fasting insulin(FINS)and FABP4 in the observation group were higher than those in the NDR group and the control group(P<0.05),and the serum NRG4 level was lower than those in the NDR group and the control group(P<0.05).The serum NRG4 level in the proliferative lesion group was lower than that in the non proliferative lesion group(P<0.05),and the FABP4 level was higher than that in the non proliferative lesion group(P<0.05).NRG4 was a protective factor for the occurrence of DR(P<0.05),while FABP4 was a risk factor for the occurrence of DR(P<0.05).The area under the curve(AUC)of serum NRG4 and FABP4 for diagnosing DR was 0.850 and 0.866,and the AUC of combined diagnosis was 0.930.The efficacy of the combination of the two was superior to that of the individual diagnosis of serum NRG4 and FABP4(Z_(combination-NRG4)=3.467,Z_(combination-FABP4)=2.987,P=0.001,0.002).Conclusion The serum FABP4 level in DR patients is greatly incre

关 键 词：糖尿病视网膜病变 2型糖尿病 血清神经调节蛋白 血清脂肪酸结合蛋白 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]