2型糖尿病患者尿液HA/CD44/RHAMM水平与糖尿病肾病的相关性研究  

Correlation between urine HA/CD44/RHAMM levels and diabetic kidney disease in patients with type 2diabetes mellitus

作　　者：祝永越 陈洋 祁冰雪 芦小单[2] ZHU Yongyue;CHEN Yang;QI Bingxue;LU Xiaodan(School of Clinical Medicine,Changchun University of Traditional Chinese Medicine,Changchun130117,China;Precision Molecular Medicine Center,Jilin Provincial People’s Hospital,Changchun 130021,China)

机构地区：[1]长春中医药大学临床医学院,吉林长春130117 [2]吉林省人民医院精准分子医学中心,吉林长春130021

出　　处：《中国实验诊断学》2025年第4期406-413,共8页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省自然科学基金面上项目(YDZJ202301ZYTS175);吉林省杰出青年基金项目(20240101007JJ)。

摘　　要：目的探讨2型糖尿病(T2DM)患者尿液透明质酸(HA)及其受体CD44、透明质酸运动受体(RHAMM)水平与糖尿病肾病(DKD)的相关性。方法对2023年5月至10月在吉林省人民医院内分泌科收治的96例T2DM患者进行横断面研究,根据eGFR将患者分为3组,包括(1)非肾功能不全组:eGFR≥90 mL/(min·1.73 m^(2));(2)轻度肾功能不全组:90>eGFR≥60 mL/(min·1.73 m^(2));(3)重度肾功能不全组:eGFR<60 mL/(min·1.73 m^(2))。收集患者的尿液、血清标本及一般临床资料,采用ELISA法检测尿液中HA、CD44、RHAMM水平,流式免疫荧光技术检测血清炎症因子白介素6、血管内皮生长因子A、肿瘤坏死因子-α、转化生长因子-β水平。采用单因素方差分析或Kruskal-Wallis检验比较组间基线资料的差异;采用Spearman相关分析评价患者尿液HA、CD44、RHAMM水平与一般临床资料、生化指标以及肾功能各指标的相关性;采用多元线性回归分析与eGFR相关的影响因素;用受试者工作特征(ROC)曲线评价诊断效能。结果3组患者之间尿液HA、CD44、RHAMM水平均有显著性差异(P<0.001)。eGFR与尿液HA(r^(2)=0.5319,P<0.001)、CD44(r^(2)=0.2699,P<0.001)、RHAMM(r^(2)=0.6557,P<0.001)有相关性,且均呈显著负相关。尿液CD44水平诊断DKD的ROC曲线下面积为0.802。结论DKD患者尿液HA、CD44、RHAMM水平明显升高,与eGFR呈明显负相关,其中尿液CD44水平对DKD的诊断有一定的预测价值。Objective To explore the correlation between urinary hyaluronic acid(HA)and its receptors CD44and RHAMM levels in patients with type 2diabetes mellitus(T2DM)and diabetic kidney disease(DKD).Methods A cross-sectional study was conducted on 96patients with type 2diabetes mellitus(T2DM)admitted to the Endocrinology Department of Jilin Provincial People’s Hospital from May to October 2023,and patients were divided into three groups based on estimated glomerular filtration rate(eGFR):(1)Non-renal-dysfunction Group:eGFR≥90mL/(min·1.73m^(2));(2)Mild-renal-dysfunction Group:90>eGFR≥60 mL/(min·1.73 m^(2));(3)Severe-renal-dysfunction Group:eGFR<60mL/(min·1.73m^(2)).Urine and serum samples,as well as general clinical data,were collected.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of HA,CD44,and RHAMM in urine,and flow cytometric immunofluorescence technology was used to detect serum inflammatory factors including interleukin-6,vascular endothelial growth factor A,tumor necrosis factor-α,and transforming growth factor-β.One-way ANOVA or Kruskal-Wallis test was used to compare baseline data among groups;Spearman’s correlation analysis was used to evaluate the correlation between urinary HA,CD44,RHAMM and general clinical data,biochemical indicators,and renal function indicators;multiple linear regression analysis was used to analyze factors associated with eGFR;and the receiver operating characteristic(ROC)curve was used to assess diagnostic efficacy.Results There were significant differences in urinary HA,CD44,and RHAMM levels among the three groups(P<0.001).eGFR was significantly and negatively correlated with urinary HA(r^(2)=0.5319,P<0.001),CD44(r^(2)=0.2699,P<0.001),and RHAMM(r^(2)=0.6557,P<0.001).The area under the ROC curve for urinary CD44level in diagnosing DKD was 0.802.Conclusion In patients with diabetic kidney disease(DKD),the levels of urinary HA,CD44,and RHAMM are significantly elevated and show a clear negative correlation with eGFR.Among these,the level of urinary CD44ha

关 键 词：2型糖尿病 糖尿病肾病 透明质酸 CD44 RHAMM 炎症因子 

分 类 号：R587.2[医药卫生—内分泌]