摘要
目的探讨纤维蛋白原/前白蛋白比值(FPR)和纤维蛋白原/白蛋白比值(FAR)与早期DKD患者肾小管损伤的相关性。方法选取2020年2月至2021年3月于徐州医科大学附属医院内分泌科住院的388例T2DM患者,根据UACR水平分为正常白蛋白尿组(NUAlb,n=200)及微量白蛋白尿组(MUAlb,n=188),比较两组一般资料及生化指标。再进行二次分组,根据FPR三分位数分为低FPR组(LFPR,n=129)、中FPR组(MFPR,n=129)及高FPR组(HFPR,n=130);根据FAR三分位数分为低FAR组(LFAR组,n=129)、中FAR组(MFAR,n=130)及高FAR组(HFAR,n=129)。收集二次分组各组生化指标、尿液肾小管损伤标志物,计算FPR、FAR、中性粒细胞/淋巴细胞比值(NLR),分析FPR、FAR及NLR与肾小管损伤标志物的相关性。结果 MUAlb组FPR、FAR高于NUAlb组(P<0.05)。随着FPR、FAR三分位数递增,UACR、β2-MG水平逐渐升高(P<0.05),HFAR组α1-MG高于LFAR、MFAR组(P<0.05)。Spearman相关分析显示,FPR、FAR与UACR、α1微球蛋白(α1-MG)、β2微球蛋白(β2-MG)呈正相关(P<0.05)。受试者工作特征曲线显示,FPR判定UACR≥30 mg/g、α1-MG>12 mg/L、β2-MG>0.3 mg/L曲线下面积(AUC)分别为0.742、0.710、0.721,均优于FAR(AUC=0.650、0.628、0.638)和NLR(AUC=0.693、0.661、0.691)。结论 FPR和FAR与早期DKD患者肾小管损伤密切相关,FPR较FAR、NLR更能综合反映肾小管损伤。
Objective To investigate the association between fibrinogen/prealbumin ratio(FPR)or fibrinogen/albumin ratio(FAR)and renal tubular injury in patients with early diabetic kidney disease(EDKD).Methods A total of 388 patients with T2 DM who were hospitalized in the affiliated hospital of Xuzhou Medical University from February 2020 to March 2021 were enrolled in this study.All the patients were divided into two groups according to their UACR levels:normoalbuminuria group(NUAlb,n=200)and microalbuminuria group(MUAlb,n=188).General clinical characteristics and biochemical index were compared between the two groups.After that,the patients were divided into low FPR group(LFPR,n=129),medium FPR group(MFPR,n=129)and high FPR group(HFPR,n=130)based on the tertile level of FPR.Then they were further divided into low FAR group(LFAR,n=129),medium FAR group(MFAR,n=130)and high FAR group(HFAR,n=129)based on the tertile level of FAR.Biochemical indexes and markers of urinary renal tubular injury were collected.FPR,FAR,and neutrophil to lymphocyte ratio(NLR)were calculated.The relationships between FPR,FAR,NLR and renal tubular injury biomarkers were analyzed.Results FPR and FAR were higher in MUAlb group than in NUAlb group(P<0.05).The levels of UACR and β2-MG increased gradually with the increase of FPR and FAR tertile(P<0.05).The level of α1-MG was significantly higher in HFAR group than in LFAR and MFAR group(P<0.05).Spearman correlation analysis showed that there were significant positive correlations between FPR,FAR and UACR,α1-MG and β2-MG(P<0.05).ROC curve analysis showed that the AUC of FPR in predicting UACR≥30 mg/g,α1-MG>12 mg/L,β2-MG>0.3 mg/L(AUC=0.742,0.710,0.721)were all higher than those of FAR(AUC=0.650,0.628,0.638)and NLR(AUC=0.650,0.628,0.638).Conclusion Both FPR and FAR are closely related to renal tubular injury in patients with EDKD.FPR can reflect renal tubular injury more comprehensively compared with FAR and NLR.
作者
沃眉宏
陆雨纯
靳津
苏倍倍
张艺凡
应长江
周晓燕
WO Meihong;LU Yuchun;JIN Jin(The First Clinical Medical College of Xuzhou Medical University,Xuzhou 221000,China)
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2021年第12期896-901,共6页
Chinese Journal of Diabetes
基金
国家自然科学基金(81701298)
中国博士后科学基金(2019M651970)。