尿Haptoglobin及Periostin与2型糖尿病患者肾脏损害的相关性研究
发布时间：2018-09-06 14:42
【摘要】：目的:通过检测Haptoglobin(HPt)及Periostin(PN)在2型糖尿病(type 2 diabetes mellitus,T2DM)及糖尿病肾病(diabetic kidney disease,DKD)患者尿液中的浓度并与尿白蛋白、尿N-乙酰-β-D-氨基葡萄糖苷酶(urinary N-and acetyl beta-D-Glucosaminidase,UNAG)、尿α1-微球蛋白(α1-microglobulin,α1-MG)、血清胱抑素C(cystatin C,Cys-C)、肾小球滤过率(eGFR)等相关肾脏损伤指标进行比较分析,探讨尿HPt及PN与T2DM患者肾脏损害的相关性。方法:选取于我院内分泌科就诊的T2DM患者119例,根据尿白蛋白/肌酐(UACR)比值分为正常白蛋白尿组(NAU组,n=36)、微量白蛋白尿组(MAU组,n=53)及大量白蛋白尿组(CDN组,n=30),同时选取同期健康体检者31例作为对照组(NC组)。运用酶联免疫吸附法检测受试者尿液HPt及PN浓度,所有结果经尿肌酐(creatinine,Cr)校正。结果:1.尿HPt/Cr和尿PN/Cr水平在T2DM各组与NC组比较均显著升高,且尿HPt/Cr在T2DM各组中随UACR水平升高而升高,即NAU组MAU组CDN组,差异有统计学意义(P0.05);尿PN/Cr水平在T2DM各组中虽然随UACR水平升高而升高,但各组间比较差异无统计学意义(P0.05)。2.Cys-C、尿α1-MG/Cr、UNAG/Cr在T2MD各组均显著高于NC组,且Cys-C、UNAG/Cr在T2MD各组中随UACR升高而递增,即NAU组MAU组CDN组,差异有统计学意义(P0.05);尿α1-MG/Cr在MAU组、CDN组显著高于NAU组(P0.05)。eGFR在CDN组显著降低于其余各组(P0.05)。3.Spearman相关分析显示,尿HPt/Cr与Cys-C、UACR、尿α1-MG/Cr、UNAG/Cr、尿PN/Cr呈正相关,与eGFR呈负相关(P0.05);尿PN/Cr与UACR、尿α1-MG/Cr、UNAG/Cr呈正相关,与eGFR呈负相关(P0.05),与Cys-C无明显相关(P=0.05)。4.以UACR=30μg/mg为分界值作ROC曲线,尿HPt/Cr曲线下面积为0.804,尿PN/Cr曲线下面积为0.665,可见尿HPt/Cr曲线下面积大于尿PN/Cr曲线下面积。结论:1.尿HPt和尿PN都与T2MD患者肾脏损害有关,二者可能是2型糖尿病肾病的生物标志物,但尿PN对T2MD患者肾脏损害病情变化的敏感性还需要进一步的研究。2.尿HPt对T2MD患者肾脏损害的严重程度判断以及病情监测具有十分重要的意义。3.尿HPt对早期DKD的诊断价值优于尿PN,尿液取材方便、无创伤、无副作用、可反复操作,因而尿HPt可能成为诊断早期DKD及监测DKD进展的理想生物标志物。
[Abstract]:Objective: to detect the concentrations of Haptoglobin (HPt) and Periostin (PN) in urine of patients with type 2 diabetes mellitus (type 2 diabetes mellitus,T2DM) and diabetic nephropathy (diabetic kidney disease,DKD). Urinary N- acetyl- 尾 -D- glucosaminidase (urinary N-and acetyl beta-D-Glucosaminidase,UNAG), urine 伪 1-microglobulin (伪 1-MG), serum cystatin (C (cystatin C), glomerular filtration rate (eGFR) were compared and analyzed to explore the correlation between urinary HPt and PN and renal damage in T2DM patients. Methods: 119 patients with T2DM were selected from Endocrinology Department in our hospital. According to the ratio of urinary albumin / creatinine (UACR), it was divided into normal albuminuria group (NAU group), microalbuminuria group (MAU group) and large albuminuria group (CDN group). 31 healthy volunteers were selected as control group (NC group). Urine HPt and PN concentrations were measured by enzyme linked immunosorbent assay (Elisa). All the results were corrected by urinary creatinine (creatinine,Cr). The result is 1: 1. The levels of urinary HPt/Cr and urinary PN/Cr in T2DM group were significantly higher than those in NC group, and the level of urinary HPt/Cr in T2DM group increased with the increase of UACR level, that is, NAU group MAU group CDN group. The urinary PN/Cr level in T2DM group increased with the increase of UACR level, but there was no significant difference among the three groups (P0.05). 2. Cys-C. urine 伪 1-MG / Cr UNAG / Cr level in T2MD group was significantly higher than that in NC group, and Cys-C,UNAG/Cr increased with UACR in T2MD group. There was significant difference between CDN group and MAU group in NAU group (P0.05), urinary 伪 1-MG/Cr in MAU group was significantly higher than that in NAU group (P0.05) .eGFR in CDN group was significantly lower than that in other groups (P0.05). 3. Spearman correlation analysis showed that there was a positive correlation between urinary HPt/Cr and Cys-C,UACR, urine 伪 1-MGp-CrUNAGCr-Cr, urine PN/Cr. There was a negative correlation between urinary PN/Cr and UACR, 伪 1-MG / CrUNAG / Cr, a negative correlation with eGFR (P0.05), and no significant correlation with Cys-C (P0. 05). 4. With UACR=30 渭 g/mg as the boundary value, the area under the HPt/Cr curve was 0.804, and the area under the PN/Cr curve was 0.665. The area under the HPt/Cr curve was larger than that under the PN/Cr curve. Conclusion 1. Both urinary HPt and urinary PN are associated with renal damage in T2MD patients. Both may be biomarkers of type 2 diabetic nephropathy, but the sensitivity of urinary PN to renal damage in T2MD patients needs further study. Urinary HPt is of great significance in judging the severity and monitoring of renal damage in patients with T2MD. The diagnostic value of urine HPt for early DKD is better than that for urine PN,. Urine HPt may be an ideal biomarker for diagnosing early DKD and monitoring the progression of DKD.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R692.9
本文编号：2226671
[Abstract]:Objective: to detect the concentrations of Haptoglobin (HPt) and Periostin (PN) in urine of patients with type 2 diabetes mellitus (type 2 diabetes mellitus,T2DM) and diabetic nephropathy (diabetic kidney disease,DKD). Urinary N- acetyl- 尾 -D- glucosaminidase (urinary N-and acetyl beta-D-Glucosaminidase,UNAG), urine 伪 1-microglobulin (伪 1-MG), serum cystatin (C (cystatin C), glomerular filtration rate (eGFR) were compared and analyzed to explore the correlation between urinary HPt and PN and renal damage in T2DM patients. Methods: 119 patients with T2DM were selected from Endocrinology Department in our hospital. According to the ratio of urinary albumin / creatinine (UACR), it was divided into normal albuminuria group (NAU group), microalbuminuria group (MAU group) and large albuminuria group (CDN group). 31 healthy volunteers were selected as control group (NC group). Urine HPt and PN concentrations were measured by enzyme linked immunosorbent assay (Elisa). All the results were corrected by urinary creatinine (creatinine,Cr). The result is 1: 1. The levels of urinary HPt/Cr and urinary PN/Cr in T2DM group were significantly higher than those in NC group, and the level of urinary HPt/Cr in T2DM group increased with the increase of UACR level, that is, NAU group MAU group CDN group. The urinary PN/Cr level in T2DM group increased with the increase of UACR level, but there was no significant difference among the three groups (P0.05). 2. Cys-C. urine 伪 1-MG / Cr UNAG / Cr level in T2MD group was significantly higher than that in NC group, and Cys-C,UNAG/Cr increased with UACR in T2MD group. There was significant difference between CDN group and MAU group in NAU group (P0.05), urinary 伪 1-MG/Cr in MAU group was significantly higher than that in NAU group (P0.05) .eGFR in CDN group was significantly lower than that in other groups (P0.05). 3. Spearman correlation analysis showed that there was a positive correlation between urinary HPt/Cr and Cys-C,UACR, urine 伪 1-MGp-CrUNAGCr-Cr, urine PN/Cr. There was a negative correlation between urinary PN/Cr and UACR, 伪 1-MG / CrUNAG / Cr, a negative correlation with eGFR (P0.05), and no significant correlation with Cys-C (P0. 05). 4. With UACR=30 渭 g/mg as the boundary value, the area under the HPt/Cr curve was 0.804, and the area under the PN/Cr curve was 0.665. The area under the HPt/Cr curve was larger than that under the PN/Cr curve. Conclusion 1. Both urinary HPt and urinary PN are associated with renal damage in T2MD patients. Both may be biomarkers of type 2 diabetic nephropathy, but the sensitivity of urinary PN to renal damage in T2MD patients needs further study. Urinary HPt is of great significance in judging the severity and monitoring of renal damage in patients with T2MD. The diagnostic value of urine HPt for early DKD is better than that for urine PN,. Urine HPt may be an ideal biomarker for diagnosing early DKD and monitoring the progression of DKD.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R692.9
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