摘要
目的:尿维生素D结合蛋白(urine vitamin D-binding protein,uVDBP)的排泄可能参与2型糖尿病(Type 2diabetic mellitus,T2DM)患者早期肾损害的发生和发展,本研究旨在探讨u VDBP在T2DM患者中的检测意义及其与肾小管的关系,为T2DM肾损害的早期诊断提供新的方向。方法:纳入符合入组标准的105例T2DM患者(患者组)和同期募集健康体检者30例(正常对照组),收集所有入组人员的一般资料及血、尿液生物化学指标,并采用ELISA法检测uVDBP、尿人肾损伤因子-1(urine kidney injury molecule 1,uKIM-1)、尿中性粒细胞明胶酶相关脂质运载蛋白(urine neutrophil gelatinase-associated lipocalin,uNGAL)、尿视黄醇结合蛋白(urine retinol-binding protein,uRBP)水平,再经尿肌酐(creatinine,Cr)校正为u VDBP/Cr、uKIM-1/Cr、u NGAL/Cr、u RBP/Cr。采用Pearson和Spearman相关性检验分析uVDBP/Cr与尿白蛋白肌酐比值(urine albumin-to-creatinine ratio,UACR)、肾小球滤过率估计值(estimated glomerular filtration rate,eGFR)及肾小管损伤标志物之间的相关性;采用多重线性回归和受试者操作特征曲线分析uVDBP/Cr与UACR和eGFR的相关性。结果:与正常对照组相比,患者组的uVDBP/Cr升高(P<0.05),且与UACR呈正相关(r=0.774,P<0.01);与e GFR呈负相关(r=-0.397,P<0.01)。两组之间的uKIM-1/Cr、uNGAL/Cr、uRBP/Cr水平差异均有统计学意义(均P<0.01);u VDBP/Cr与uKIM-1/Cr(r=0.752, P<0.01)、 u NGAL/Cr(r=0.644, P<0.01)、uRBP/Cr(r=0.812, P<0.01)均呈正相关。uVDBP/Cr对T2DM早期肾损害患者评估的灵敏度为90.0%,特异度为82.9%;eGFR对T2DM早期肾损害患者评估的灵敏度为75.0%,特异度为72.6%。结论:uVDBP/Cr可以作为早期评估T2DM患者肾损害的生物学标志物。
Objective:The excretion of urinary vitamin D-binding protein(uVDBP)is related to the occurrence and development of early-stage renal damage in patients with Type 2 diabetes(T2DM).This study aims to explore the significance of detecting uVDBP in T2DM patients and its relationship with renal tubules,and to provide a new direction for the early diagnosis of T2DM renal damage.Methods:A total of 105 patients with T2DM,who met the inclusion criteria,were included as a patient group,and recruited 30 individuals as a normal control group.The general information and blood and urine biochemical indicators of all subjects were collected;the levels of uVDBP,and a marker of tubular injury[urine kidney injury molecule 1(uKIM-1),urine neutrophil gelatinase-associated lipocalin(uNGAL)and urine retinol-binding protein(uRBP)]were detected by enzyme-linked immunosorbent assay.The results were corrected by urinary creatinine(Cr)to uVDBP/Cr,uKIM-1/Cr,uNGAL/Cr and uRBP/Cr.The Pearson’s and Spearman’s correlation tests were used to analyze the correlation between uVDBP/Cr and urine albumin-to-creatinine ratio(UACR),estimated glomerular filtration rate(eGFR)and markers of tubular injury,and multivariate linear regression and receiver operating characteristic curve were used to analyze the correlation between uVDBP/Cr and UACR or eGFR.Results:Compared with the normal control group,the uVDBP/Cr level in the patient group was increased(P<0.05),and which was positively correlated with UACR(r=0.774,P<0.01),and negatively correlated with eGFR(r=−0.397,P<0.01).There were differences in the levels of uKIM-1/Cr,uNGAL/Cr,and uRBP/Cr between the 2 groups(all P<0.01).The uVDBP/Cr was positively correlated with uKIM-1/Cr(r=0.752,P<0.01),uNGAL/Cr(r=0.644,P<0.01)and uRBP/Cr(r=0.812,P<0.01).The sensitivity was 90.0%and the specificity was 82.9%(UACR>30 mg/g)for evaluation of uVDBP/Cr on T2DM patients with early-stage renal damage,while the sensitivity was 75.0%and the specificity was 72.6%for evaluation of eGFR on T2DM patients with early-stage renal damage.Conclusion:The uVDBP/Cr can be used as a biomarker in early-stage renal damage in T2DM patients.
作者
黄雨茜
陈斯洁
戴晴
张浩
刘妍
HUANG Yuxi;CHEN Sijie;DAI Qing;ZHANG Hao;LIU Yan(Department of Nephrology,Third Xiangya Hospital,Central South University,Changsha 410013;Department of Nephrology,Yueyang Central Hospital,Yueyang Hunan 414000,China)
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2023年第1期40-48,共9页
Journal of Central South University ：Medical Science
基金
国家自然科学基金(81870498)
湖南省自然科学基金(2021JJ31016)。
关键词
糖尿病
维生素D结合蛋白
早期肾损害
diabetic mellitus
urine vitamin D binding protein
early-stage renal damage
