摘要
目的探究糖尿病肾病患者血清Rho相关卷曲螺旋形成蛋白激酶2(ROCK2)、多配体蛋白聚糖-1(SDC-1)、脂肪细胞因子-13(Apelin-13)水平与肾功能及预后的关系。方法选取2019年11月到2021年11月该院收治的153例糖尿病肾病患者为研究组,153例单纯糖尿病患者为单纯糖尿病组;另选取同期153例体检健康人员为健康对照组。采用酶联免疫吸附试验测定血清ROCK2、SDC-1、Apelin-13水平。采用Pearson相关性分析血清ROCK2、SDC-1、Apelin-13水平与尿病肾病患者临床资料相关性,单因素及多因素Logistic回归分析糖尿病肾病患者预后不良的影响因素,绘制受试者工作特征(ROC)曲线分析血清ROCK2、SDC-1、Apelin-13水平对糖尿病肾病患者不良预后预测价值。结果与健康对照组相比,单纯糖尿病组和研究组患者血清ROCK2、SDC-1水平升高,Apelin-13水平降低,研究组患者估算肾小球滤过率(eGFR)降低,尿白蛋白与肌酐比值(UACR)升高,差异均有统计学意义(P<0.05);研究组患者血清ROCK2、SDC-1、Apelin-13水平及UACR高于单纯糖尿病组,eGFR低于单纯糖尿病组,差异均有统计学意义(P<0.05)。Pearson相关性分析结果表明,研究组患者血清ROCK2、SDC-1、Apelin-13水平与eGFR呈负相关(P<0.05),与肾脏病分期、肌酐、24 h蛋白尿和UACR指标呈正相关(P<0.05)。与良好预后组相比,不良预后组患者血清ROCK2、SDC-1、Apelin-13和UACR水平升高(P<0.05),eGFR下降(P<0.05)。单因素及多因素Logistic回归分析结果表明,血清ROCK2、SDC-1、Apelin-13水平均是患者预后的影响因素(P<0.05)。ROC曲线分析结果表明,血清ROCK2、SDC-1、Apelin-13水平三者联合预测患者预后不良的曲线下面积(AUC)显著大于ROCK2(Z=2.854,P=0.004)、SDC-1(Z=2.426,P=0.015)和Apelin-13(Z=2.172,P=0.030)单独预测。结论糖尿病肾病患者血清ROCK2、SDC-1、Apelin-13水平上升,并与肾功能相关,三者联合对患者预后预测效能较高。
Objective To investigate the relationship between serum Rho-associated coiled coil containing protein kinase 2(ROCK2),syndecan-1(SDC-1),Apelin-13 and renal function and prognosis in patients with diabetes nephropathy.Methods From November 2019 to November 2021,153 patients with diabetic nephropathy admitted to the hospital were selected as the study group,and 153 patients with simple diabetes were selected as the simple diabetes group.Another 153 healthy individuals who underwent physical examinations during the same period were selected as the healthy control group.The levels of serum ROCK2,SDC-1 and Apelin-13 were determined by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlations between the levels of serum ROCK2,SDC-1,and Apelin-13 and the clinical data of patients with urinary nephropathy.Univariate and multivariate Logistic regression analyses were conducted to analyze the influencing factors of poor prognosis in patients with diabetic nephropathy.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum ROCK2,SDC-1 and Apelin-13 for poor prognosis of patients with diabetes nephropathy.Results Compared with the healthy control group,the levels of serum ROCK2 and SDC-1 in the simple diabetes group and the study group increased,the level of Apelin-13 decreased,the estimated glomerular filtration rate(eGFR)decreased,and the ratio of urinary albumin to creatinine(UACR)increased,and the differences were statistically significant(P<0.05).The levels of serum ROCK2,SDC-1,Apelin-13 and UACR in the study group were higher than those in the simple diabetes group,while eGFR was lower than that in the simple diabetes group,and the differences were statistically significant(P<0.05).Pearson correlation analysis indicated that the levels of serum ROCK2,SDC-1,and Apelin-13 in the study group were negatively correlated with eGFR(P<0.05),and positively correlated with renal disease stage,creatinine,24-hour proteinuria,and UACR index(P<0.05).Compared with the good prognosis group,the levels of serum ROCK2,DCC-1,Apelin-13 and UACR in the poor prognosis group increased(P<0.05),and eGFR decreased(P<0.05).Univariate and multivariate Logistic regression analyses indicated that the levels of serum ROCK2,SDC-1,and Apelin-13 were all influencing factors for the prognosis of patients(P<0.05).ROC curve analysis indicated that the area under the curve(AUC)for the combined prediction of poor prognosis in patients by serum ROCK2,DCC-1,and Apelin-13 levels was significantly greater than that by ROCK2(Z=2.854,P=0.004)and DCC-1(Z=2.426,P=0.015)and Apelin-13(Z=2.172,P=0.030)were predicted separately.Conclusion The serum ROCK2,DCC-1 and Apelin-13 levels in patients with diabetic nephropathy increase and are related to renal function.The combination of the three has a relatively high predictive efficacy for the prognosis of patients.
作者
李红娟
力文
任爽
孟银苹
张柳
LI Hongjuan;LI Wen;REN Shuang;MENG Yinping;ZHANG Liu(Department of Hematology and Nephrology,Baoding Second Central Hospital,Baoding,Hebei 072750,China;Department of Endocrinology,Baoding Second Central Hospital,Baoding,Hebei 072750,China)
出处
《国际检验医学杂志》
2025年第22期2732-2737,2742,共7页
International Journal of Laboratory Medicine
基金
河北省保定市科技计划项目(2441ZF185)。
