| 徐敏,李兴旺,高修银,等.老年糖尿病肾病病人血清 6项指标检测水平与尿微量白蛋白的关系[J].安徽医药,2021,25(11):2187-2191. |
| 老年糖尿病肾病病人血清 6项指标检测水平与尿微量白蛋白的关系 |
| Study on the relationship between serum levels of 6 indicators and urinary microalbumin in elderly patients with diabetic nephropathy |
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| DOI：10.3969/j.issn.1009-6469.2021.11.015 |
| 中文关键词: 糖尿病肾病 视黄醇结合蛋白质类，血浆 老年人 2型糖尿病 血清学指标 尿微量白蛋白 |
| 英文关键词: Diabetic nephropathies Retinol-binding proteins,plasma Aged Type 2 diabetes mellitus Serological indicators Urinary microalbumin |
| 基金项目:江苏省徐州市科技计划项目( KC16SH078) |
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| 中文摘要: |
| 目的探讨血清 β2微球蛋白(β2-MG)视黄醇结合蛋白(RBP)转化生长因子 -β1(TGF-β1)中性粒细胞 /淋巴细胞比值(NLR)胱抑素C(Cys-C)以及糖化血红蛋白(HbA、1c)检测水平在老年糖尿、病肾病( DN)人群中与尿微、量白蛋白的关系。方法选取2018，年 5月至 2020年 5月徐州医科大学附属医院收治的老年 2型糖尿病(T2DM)病人 154例，按照尿微量白蛋白水平分为三组， A组尿微量白蛋白小于 30 mg/L；B组尿微量白蛋白 30~300 mg/L；C组尿微量白蛋白大于 300 mg/L。同时选取 51例健康体检者作为对照组，分别测定四组的 β2-MG、RBP、TGF-β1、NLR，Cys-C以及 HbA1c水平，应用 ROC曲线和 Pearson相关性分析判断各指标诊断效能。结果随着尿微量白蛋白的增加， β2-MG、RBP、TGF-β1、NLR、Cys-C、HbA1c水平逐渐升高。通过 ROC曲线发现， β2-MG、RBP、TGF-β1、NLR、Cys-C、HbA1c诊断老年 T2DM出现尿微量白蛋白的截断值分别为 3.31 mg/L、63.22 mg/L、72.69 μg/L、2.31、1.15 mg/L、7.50％。各指标联合检测时，敏感度和特异度均得到明显提高。从 Pearson相关分析可以看出，上述 6项指标与尿微量白蛋白均呈正相关关系。结论老年 T2DM的 β2-MG、RBP、TGF-β1、NLR、Cys-C、HbA1c水平随着尿微量白蛋白的出现及增加而升高，可作为早期发现 DN的血清学标志，各指标联合运用诊断老年 T2DM肾功能损害的准确性明显提高。 |
| 英文摘要: |
| Objective To investigate the relationship between the levels of serum β2 microglobulin (β2-MG), retinol binding protein (RBP), transforming growth factor-β1 (TGF-β1), neutrophil/lymphocyte ratio (NLR), cystatin C (Cys-C), glycosylated hemoglobin (HbA1c) and urinary microalbumin in elderly patients with diabetic nephropathy (DN).Methods A total of 154 elderly patients withtype 2 diabetes mellitus (T2DM) admitted to the Affiliated Hospital of Xuzhou Medical University from May 2018 to May 2020 were selected and assigned into three groups according to the level of urinary microalbumin. Group A: Urinary microalbumin was less than 30mg/L; Group B: Urinary microalbumin was between 30 mg/L and 300 mg/L; Group C: Urinary microalbumin was more than 300 mg/L.At the same time, 51 patients who underwent physical examination were selected as a control group, and the levels of β2-MG, RBP, TGF-β1, NLR, Cys-C and HbA1c in 4 groups were measured respectively. ROC curve and Pearson correlation analysis were used to determine the diagnostic efficacy of each indicator.Results The levels of β2-MG, RBP, TGF-β1, NLR, Cys-C and HbA1c increased with the increase of urinary microalbumin.ROC curve showed that the cutoff values of urinary microalbumin in the diagnosis of T2DMin the elderly were 3.31 mg /L,63.22 mg/L,72.69 μg/L, 2.31,1.15 mg/L and 7.50%, respectively.The sensitivity and specificity were improved obviously when all indexes were tested together. Pearson correlation analysis showed that the 6 indexes above were positivelycorrelated with urinary microalbumin.Conclusion The levels of β2-MG,RBP,TGF-β1,NLR,Cys-C and HbA1c in elderly patients withT2DM are increased with the occurrence of DN and the progression of renal damage, which can be used as serological markers for theearly detection of diabetic nephropathy. The accuracy of the combined application of these indexes in the diagnosis of renal impairmentin elderly patients with T2DM is significantly improved. |
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