摘要
目的探讨糖尿病肾病(DKD)患者血清视黄醇结合蛋白(RBP),基质细胞衍生因子-1(SDF-1)与肾功能的关系。方法前瞻性选取2017年10月—2020年10月滨州医学院烟台附属医院收治的2型糖尿病(T2DM)患者438例,根据有无合并DKD分为单纯T2DM组(n=276)和DKD组(n=162),根据尿白蛋白/肌酐比值(UACR)分为正常(n=25),微量(n=75)以及大量白蛋白尿组(n=62),根据估算肾小球滤过率(eCFR)分为C1期(n=28),G2期(n=27),G3a+G3b期(n=35),C4期(n=39)以及G5期(n=33),分析RBP,SDF-1与肾功能指标UACR,血尿酸(UA)、血清尿素氮(BUN)、β2-微球蛋白(β2-MG),血肌酐(Scr)的关系。正态分布的计量资料以均数±标准差(Mean±SD)表示,两组间比较采用独立样本t检验,多组间比较采用单因素方差分析;计数资料组间比较采用χ^2检验。受试者操作特征曲线(ROC)用于分析RBP,SDF-1对DKD的判别价值;Pearson用于指标间的相关性分析;多元线性回归分析用于RBP的影响因素分析。结果DKD组患者的糖尿病病程长,RBP、UACR、UA、BUN、β2-MG、Ser水平高,SDF-1,eGFR低,与单纯T2DM组相比,差异具有统计学意义(P<0.05)。RBP,SDF-1判别DKD的曲线下面积为0.903,0.868,最佳截断值为70.71 mg/L,5.69 ng/mL。随着尿白蛋白和临床分期的增加,RBP、UACR、UA、BUN、β2-MG、Ser水平逐渐升高,SDF-1、eGFR逐渐降低,差异均具有统计学意义(P<0.05)。DKD患者RBP与UACR、UA、BUN、β2-MG、Ser均具有显著正相关关系(r=0.764,0.787,0.693,0.577,0.801,P<0.0001),与eGFR具有显著负相关关系(r=-0.782,P<0.0001)。SDF-1与UACR、UA、BUN、β2-MG,Ser均具有显著负相关关系(r=-0.744、-0.794、-0.666、-0.605、-0.820,P<0.0001),与eGFR具有显著正相关关系(r=0.767,P<0.0001)。多元线性回归方程为:RBP=29.852+0.007UACR+0.101UA+0.497BUN+0.034Ser-0.083eGFR(P<0.001)。结论RBP和SDF-1对T2DM人群中的DKD患者具有一定的判别价值,且DKD肾功能损伤程度与RBP呈正相关,与SDF-1呈负相关,UACR、UA、BUN、Ser�
Objective To investigate the relatiomship befween sertm retinol binudling protein(RBP),stromal cell derived factor-1(SDF-1)and renal function in patients with diabetic nephrnopathy(DKD).Methods The puatients with type 2 tdiabeles mellitus(T2DM)ahmited to Yantai Affiliated Hospital of Binhou MedlicalCollege from Oetober 2017 to Oetohber 2020 were prospectively selected,438 patients were divided into simple T2DM group(n=276)anmd DKD group(n=162)according to the presetice or absence of DKD,according to therutio of urinary albinin/creatinime(UACR)were diviled into ncormal(n=25),mieroullsamminauria(n=75)andmac roalluminuria groap(n=62),accorling to the estimated plomerular filtration rate(eCFR)were divided intoGl stage(n=28),C2 stage(n=27),C3A+C3B sliage(n=35),CAa stage(n=39)anad G5 stages(n=33).Tbe relatiorship between RBP,SDF-1 and renal function index UACR,serum uric acidl(UA)。blood urea nitrogen(BUN),B-microglolksalin(B-MG)and serum creatinine(Ser)was analyzedl.Mcasurernent data of normaldistrilution mere expressed as Mean±stamlard devistion(Mean±SD),Imolependlent samaple t-test was used forcormgarison hetween two groups,and one-way analysis of variance was tusexd for comgparison between muhiplegroups.Chi-square lest was tused to comnpare the enurmeration dlata betceen groups,Receiver operating characteristiccurve(ROC)was usnxd to analyze the diseriminant value of RBP an SDF-1 for DKD.Pearsun was used forcorrelation antalysis among indicators.Mulivariate linear regression analysis was useodl to arsalyse the influencingfnctors od RBP.Results In the DKD group,the duration of diabetes waus longer,the levels af RBP,UACR,UA,BUN,β2-MG,Ser were high,SDF-1 anl eGFR were lower,with statistically signifieant dliffer encem compared withthe simple T2DM group(P<0.05).The areas tander the curve of RBP and SDF-1 to dlistinguish DKD were 0.903 and 0.868.and the opimal cut-off values was 70.7l mg/L and 5.69 ng/mL.With the incrase of urinary albuminand clinical stage,the levels of RBP,UACR,UA,BUN,β2-MG,Ser increased pralaally
作者
林良妍
金勇君
姚小燕
滕雅芹
赵田田
金青松
张冬冬
尚红霞
Lin Liangyan;Jin Yongjun;Yao Xiaoyan;Teng Yaqin;Zhao Tiantian;Jin Qingsong;Zhang Dongdong;Shang Hongxia(Department of Endocrinology and Metabolism,Yantai Affiliated Hospital of Binzhou Medical College,Yantai 264100,China)
出处
《国际外科学杂志》
2021年第3期184-189,F0004,共7页
International Journal of Surgery
关键词
糖尿病肾病
视黄醇结合蛋白
基质细胞衍生因子-1
肾功能
关系
Diabetic kidney disease
Retinol binding protein
Stromal cell derived factor-1
Renal function
Relationship
