糖尿病肾病患者血清PCSK9、GRP78水平及与冠脉血管钙化的关系  

Levels of Serum PCSK9 and GRP78 in Patients with Diabetes Nephropathy and Their Relationship with Coronary Vascular Calcification

作　　者：赵淑洁 刘美燕 郑倩倩 李娜 霍云涛 Zhao Shujie;Liu Meiyan;Zheng Qianqian(Nephrology Department,Xianxian Hospital of Traditional Chinese Medicine,Cangzhou City·Affiliated Hospital of Cangzhou Medical College,Cangzhou,Hebei 062250,China)

机构地区：[1]沧州市献县中医医院·沧州医学院附属医院肾病科,河北沧州062250 [2]定州市人民医院肾内科,河北定州073000

出　　处：《四川医学》2025年第3期259-263,共5页Sichuan Medical Journal

基　　金：河北省2024年度中医药类科学研究课题计划项目(编号:2024200)。

摘　　要：目的探讨糖尿病肾病(DKD)患者血清前蛋白转化酶枯草杆菌蛋白酶/kexin9型(PCSK9)、葡萄糖调节蛋白78(GRP78)水平及其与冠脉血管钙化的关系。方法收集2022年8月至2023年8月在我院治疗的DKD患者130例作为研究组,根据冠脉血管有无钙化分为钙化组58例,非钙化组72例。另选取本院同期90例健康体检者作为对照组。收集研究组所有临床资料进行分析;酶联免疫吸附测定(ELISA)法检测研究组和对照组的血清PCSK9、GRP78水平;多因素Logistic回归分析DKD患者冠脉血管钙化发生的影响因素;ROC曲线探究血清PCSK9、GRP78水平对DKD患者冠脉血管钙化发生的预测价值。结果与对照组相比,研究组患者血清PCSK9、GRP78的水平均显著升高(P<0.05)。与非钙化组相比,钙化组患者糖化血红蛋白(HbA1c)、血钙、低密度脂蛋白胆固醇(LDL-C)、尿微量蛋白(mAlb)及血清PCSK9、GRP78水平均显著升高(P<0.05)。多因素Logistic回归分析显示,血清PCSK9、GRP78、HbA1c、血钙、LDL-C、mAlb水平升高是DKD患者冠脉血管钙化发生的独立危险因素(P<0.05)。ROC分析结果显示,血清PCSK9、GRP78水平单独及联合诊断DKD冠脉血管钙化发生的AUC分别为0.813、0.810、0.886,两者联合的诊断价值显著高于单独诊断(Z二者联合-PCSK9=2.067,P=0.038;Z二者联合-GRP78=2.013,P=0.044)。结论DKD患者血清PCSK9、GRP78水平升高,两者联合对DKD冠脉血管钙化发生具有较好的诊断价值。Objective To investigate the levels of serum proprotein convertase subtilisin/kexin 9(PCSK9)and glucose regulatory protein 78(GRP78)in patients with diabetic kidney disease(DKD)and their relationship with coronary vascular calcification.Methods From August 2022 to August 2023,130 DKD patients treated in our hospital were collected as the study group.They were separated into a calcified group of 58 patients and a non calcified group of 72 patients based on the presence or absence of coronary vascular calcification.Another 90 healthy examinees from our hospital were collected as the reference group.All clinical data of the study group were collected and analyzed;ELISA method was applied to detect the serum levels of PCSK9 and GRP78 in the study group and reference group;multivariate Logistic regression was applied to analyze the influencing factors of coronary vascular calcification in DKD patients;ROC curve was applied to explore the predictive value of serum PCSK9 and GRP78 levels for the occurrence of coronary vascular calcification in DKD patients.Results Compared with the reference group,the levels of serum PCSK9 and GRP78 in the study group were greatly increased(P<0.05).Compared with the non calcified group,the levels of HbA1c,blood calcium,LDL-C,mAlb,serum PCSK9 and GRP78 in the calcified group were greatly increased(P<0.05).Multivariate Logistic regression analysis showed that elevated levels of serum PCSK9,GRP78,HbA1c,blood calcium,LDL-C,and mAlb were independent risk factors for coronary vascular calcification in DKD patients(P<0.05).ROC analysis results showed that the AUC values of serum PCSK9 and GRP78 levels alone and combine for diagnosing coronary vascular calcification in DKD were 0.813,0.810,and 0.886,respectively.The diagnostic value of the combination of the two was greatly higher than that of individual diagnosis(Z combination-PCSK9=2.067,P=0.038;Z combination-GRP78=2.013,P=0.044).Conclusion The serum levels of PCSK9 and GRP78 in DKD patients are elevated,and the combination of the two has goo

关 键 词：糖尿病肾病 前蛋白转化酶枯草杆菌蛋白酶/kexin9型 葡萄糖调节蛋白78 冠脉血管钙化 

分 类 号：R578.2[医药卫生—消化系统]