在早期糖尿病肾病中尿丝氨酸蛋白酶Corin水平与临床分期的相关性研究  

Association of urinary serine protease Corin with clinical staging in early diabetic kidney disease

作　　者：田文倩 陆静谊 陈丹阳 李飒 刘诗语 张笑盈 庞万君 胡亚会 Tian Wenqian;Lu Jingyi;Chen Danyang;Li Sa;Liu Shiyu;Zhang Xiaoying;Pang Wanjun;Hu Yahui(Department of Clinical Laboratory,Henan Provincial People′s Hospital,People′s Hospital of Zhengzhou University,People′s Hospital of Henan University,Zhengzhou 450003,China;The Fifth Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450003,China;Department of Laboratory Medicine,College of Medicine,Zhengzhou University,Zhengzhou 450052,China;Medical Clinical Laboratory,The Fifth Clinical Medical College of Henan University of Chinese Medicine/Zheng Zhou People′s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院、郑州大学人民医院、河南大学人民医院检验科,郑州450003 [2]河南中医药大学第五临床医学院,郑州450003 [3]郑州大学医学院,郑州450052 [4]河南中医药大学第五临床医学院、郑州人民医院医学检验科,郑州450003

出　　处：《中华内分泌代谢杂志》2025年第2期120-128,共9页Chinese Journal of Endocrinology and Metabolism

基　　金：河南省自然科学基金青年项目(222300420220);河南省医学科技攻关计划联合共建项目(LHGJ20210702)。

摘　　要：目的探讨尿丝氨酸蛋白酶(Corin)在早期糖尿病肾病(diabetic kidney disease,DKD)患者中的水平及与临床分期的相关性。方法选取2023年4月至2023年12月在河南省两家三甲医院确诊的2型糖尿病患者173例作为研究对象,健康体检者120名作为对照组。收集两组临床基本信息和实验室检测指标,收集尿液检测Corin水平。根据估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)将糖尿病患者分为G1~G5期;再将早期DKD(G1~G3期)患者按尿白蛋白/肌酐比值(urinary albumin-to-creatinine ratio,ACR)分为A1~A3亚组。Spearman相关分析评估尿Corin与其他指标间的相关性,线性回归分析早期DKD患者尿Corin的影响因素,logistic回归分析早期DKD的影响因素,受试者工作特征曲线(ROC)分析尿Corin在早期DKD中的诊断价值。结果与健康对照组相比,早期DKD患者尿Corin升高,且随ACR的升高而升高(P<0.05)。尿Corin与血肌酐(r=0.570)、尿素(r=0.458)、胱抑素C(r=0.693)、ACR(r=0.616)、尿转铁蛋白(r=0.448)、尿α1微球蛋白(r=0.507)、尿N-乙酰-β-D-氨基葡萄糖苷酶(r=0.388)及A亚组(r=0.692)呈正相关,与eGFR(r=-0.647)、白蛋白(r=-0.312)呈负相关(均P<0.05)。仅eGFR为尿Corin的独立影响因素。Logistic回归分析在校正了混杂因素后,尿Corin仍为早期DKD的独立影响因素。ROC曲线分析尿Corin诊断早期DKD的AUC、截断值、敏感度、特异度为0.842(95%CI 0.791~0.892;P<0.001)、2226.04 pg/mL、0.712、0.858。结论早期DKD患者尿Corin升高,且与临床分期相关。尿Corin是早期DKD的独立影响因素,尿Corin对诊断早期DKD预测价值较好。Objective To investigate the level of urinary serine protease(Corin)in early diabetic kidney disease(DKD)and its correlation with clinical stage.Methods One hundred and seventy-three patients with type 2 diabetes mellitus(DM)from two tertiary A hospitals in Henan,diagnosed between April 2023 and December 2023 were selected as the research group,and 120 healthy subjects were selected as the control group.Basic clinical information and laboratory data were collected,and urinary Corin level was detected.DM patients were classified into G1-G5 stages based on estimated glomerular filtration rate(eGFR),and those in the early DKD stages(G1-G3)were further divided into A1-A3 subgroups based on urinary albumin/creatinine ratio(ACR).Spearman correlation analysis was performed to assess relationships between urinary Corin and other indicators,linear regression analysis identified factors influencing urinary Corin in early DKD patients,logistic regression analysis evaluated the risk factors for early DKD,and receiver operating characteristic(ROC)curve analysis determined the diagnostic value of urinary Corin in early DKD.Results Urinary Corin levels were significantly higher in early DKD patients compared to healthy controls,with levels increasing as ACR rose(P<0.05).Urinary Corin was positively associated with serum creatinine(r=0.570),urea(r=0.458),cystatin C(r=0.693),ACR(r=0.616),urinary transferrin(r=0.448),urinaryα1 microglobulin(r=0.507),urinary n-acetyl-β-D-glucosaminase(r=0.388)and A subgroup(r=0.692)while was negatively correlated with eGFR(r=-0.647),albumin(r=-0.312)(all P<0.05).eGFR was the only independent factor affecting urinary Corin.After adjusting for confounding factors in logistic regression analysis,urinary Corin was still an independent influencing factor for early DKD.ROC curve analysis indicated that urinary Corin had a diagnostic AUC of 0.842(95%CI 0.791-0.892,P<0.001),with a cut-off value of 2226.04 pg/mL,sensitivity of 0.712,and specificity of 0.858 for early DKD diagnosis.Conclusions Urinary Cori

关 键 词：尿丝氨酸蛋白酶 糖尿病肾病 早期 临床分期 

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