摘要
目的妊娠期糖尿病(gestational diabetes mellitus,GDM)患者发生糖尿病肾病(diabetic kidney disease,DKD)的风险显著升高。本研究旨在评价炎症因子(TNF-α、IL-6)、氧化应激指标(SOD、ROS)对GDM早期肾损伤的诊断价值。方法纳入2020年1月至2023年12月本院收治的GDM患者162例,分为正常组(n=91)和肾损伤组(n=71)。通过二元Logistic回归构建联合预测模型,受试者工作特征曲线(ROC)评估诊断效能。结果肾损伤组TNF-α、IL-6、ROS水平显著高于正常组(P<0.001),SOD活性显著降低(P<0.001)。单项指标中,ROS的ROC曲线下面积(AUC)最高,为0.87,灵敏度80.28%,特异性75.82%;联合模型AUC达0.97,灵敏度95.77%,特异性89.01%。多因素分析显示,TNF-α、IL-6、ROS分别为肾损伤独立危险因素(OR=1.146、1.014、1.089),SOD为保护因素(OR=0.936)。相关性分析表明,TNF-α与IL-6和ROS呈显著正相关(r=0.257和0.421),与SOD呈显著负相关(r=-0.231),IL-6与ROS呈显著正相关(r=0.182),与SOD呈显著负相关(r=-0.196),SOD与ROS呈显著负相关(r=-0.265)。结论TNF-α、IL-6、SOD及ROS联合检测可显著提高GDM早期肾损伤的诊断效能,该模型为临床提供了一种高灵敏度的诊断方法。
Objective Pregnant women with gestational diabetes mellitus(GDM)could have high risk of developing diabetic kidney disease(DKD).We aimed to evaluate the diagnostic value of inflammatory factors(TNF-α,IL-6)and oxidative stress markers(SOD,ROS)in early GDM-related renal injury.Methods A total of 162 GDM patients admitted to our hospital from January,2020 to December,2023 were enrolled in this study.Based on the urine albumin-to-creatinine ratio(ACR),these participants were divided into a normal group(n=91)and a renal injury group(n=71).A binary logistic regression model was constructed,and diagnostic efficacy was evaluated using Receiver Operating Characteristic(ROC)curves.Results The renal injury group exhibited significantly higher levels of TNF-α,IL-6,and ROS(P<0.001),but lower SOD activity(P<0.001)compared to the normal group.Among individual markers,ROS showed the highest AUC of 0.87,with 80.28%sensitivity and 75.82%specificity.The combined model achieved an AUC of 0.97,with 95.77%sensitivity and 89.01%specificity.Multivariate analysis identified TNF-α,IL-6,and ROS as independent risk factors(OR=1.146,1.014,1.089),while SOD acted as a protective factor(OR=0.936).Correlation analysis revealed positive associations between TNF-αand IL-6/ROS(r=0.257,0.421),but a negative correlation between TNF-αand SOD(r=-0.231).IL-6 showed a significant positive correlation with ROS(r=0.182),but a significant negative correlation with SOD(r=-0.196),while SOD exhibited a significant negative correlation with ROS(r=-0.265).Conclusion Combined detection of TNF-α,IL-6,SOD,and ROS can significantly improve the diagnostic accuracy of early GDM-related renal injury.This model could serve as a high-sensitivity screening tool for clinical practice.
作者
刘小平
吴蓉
冉冉
杨林林
徐福强
LIU Xiaoping;WU Rong;RAN Ran;YANG Linlin;XU Fuqiang(Department of Obstetrics and Gynecology,General Hospital of North China Petroleum Administration,Renqiu 062550,China;Department of Obstetrics,Beijing You’an Hospital,Affiliated with Capital Medical University,Beijing 100069,China;Department of Innovative Medicine,General Hospital of the People’s Liberation Army,Beijing 100853,China;Department of Gynecology,Beijing You’an Hospital,Capital Medical University,Beijing 100069,China)
出处
《标记免疫分析与临床》
2025年第5期947-951,1022,共6页
Labeled Immunoassays and Clinical Medicine
基金
国家重点研发计划(编号:2020YFC2004604)。
关键词
妊娠期糖尿病
糖尿病肾病
炎症因子
氧化应激指标
联合模型
Gestational diabetes mellitus
Diabetic kidney disease
Inflammatory cytokines
Oxidative stress markers
Combined predictive model
