摘要
目的 分析早期糖尿病肾病(DN)患者血清脂联素(ADPN)、糖化血红蛋白(HbA_(1)c)的表达及临床意义。方法 选取2022年10月至2024年7月于南阳市中医院就诊的早期DN患者、临床期DN患者各81例,基于改善全球肾脏病预后组织(KDIGO)指南中尿白蛋白/肌酐比值(UACR)、尿白蛋白排泄率水平进行诊断和分组,分别纳入早期DN组、临床期DN组,另选取同期81例糖尿病患者作为单纯糖尿病组,比较各组血清ADPN、HbA_(1)c水平,并分析血清ADPN、HbA_(1)c与肾脏病变程度的关系。结果 与单纯糖尿病组比较,临床期DN组、早期组血清ADPN水平均降低,且临床期DN组血清ADPN水平低于早期组;与单纯糖尿病组比较,临床期DN组、早期组HbA_(1)c水平均升高,而临床期DN组HbA_(1)c水平高于早期组,差异均有统计学意义(P<0.05);与单纯糖尿病组比较,早期组和临床期DN组血肌酐(Cr)、血尿素氮(BUN)、UACR水平均升高,且临床期DN组高于早期组;早期组和临床期DN组估算肾小球滤过率(eGFR)水平均降低,且临床期DN组低于早期组,差异均有统计学意义(P<0.05);经Spearman相关性分析,血清ADPN与eGFR呈正相关、与BUN、Cr、UACR呈负相关(P<0.05);HbA_(1)c水平与BUN、Cr、UACR呈正相关、与eGFR呈负相关(P<0.05);绘制受试者工作特征曲线(ROC)曲线,结果显示,血清ADPN、HbA_(1)c及联合评估早期DN的曲线下面积(AUC)分别为0.836、0.604、0.853,具有一定价值,且联合预测的价值更高。结论 早期DN患者血清ADPN降低,HbA_(1)c升高,与患者肾功能变化有关,评估早期DN的应用价值显著。
Objective To analyze the expression and clinical significance of serum adiponectin(ADPN)and glycosylated hemoglobin(HbA_(1)c)in patients with early diabetic nephropathy(DN).Methods A total of 81 patients with early DN and 81 patients with clinical DN who visited Nanyang Hospital of Traditional Chinese Medicine from October 2022 to July 2024 were selected for diagnosis and grouping based on the urinary albumin/creatinine ratio(UACR)and urinary albumin excretion rate levels in the KDIGO guidelines,and were respectively included in the early DN group and the clinical DN group.In addition,81 patients with diabetes in the same period were selected as the simple diabetes group.The levels of serum ADPN and HbA_(1)c in each group were compared,and the relationship between serum ADPN,HbA_(1)c and the degree of kidney disease was analyzed.Results Compared with the simple diabetes group,the serum ADPN levels in the clinical DN group and the early group were lower,and the serum ADPN levels in the clinical DN group were lower than those in the early group.Compared with the simple diabetes group,the HbA_(1)c level in the clinical DN group and the early group increased,while the HbA_(1)c level in the clinical DN group was higher than that in the early group,with a statistically significant difference(P<0.05).Compared with the simple diabetes group,the levels of serum creatinine(Cr),blood urea nitrogen(BUN),and urine microalbumin/creatinine ratio(UACR)in the early group and the clinical DN group were all increased,and those in the clinical DN group were higher than those in the early group.The glomerular filtration rate(eGFR)levels in both the early group and the clinical DN group decreased,and the EGFR level in the clinical DN group was lower than that in the early group,with statistically significant differences(P<0.05).According to Spearman correlation analysis,serum ADPN was positively correlated with eGFR and negatively correlated with BUN,Cr,and UACR(P<0.05).HbA_(1)c levels were positively correlated with BUN,Cr,UACR,and negatively correlated with eGFR(P<0.05).ROC curves showed that the AUC of serum ADPN,HbA_(1)c,and combined assessment of early DN were 0.836,0.604,and 0.853,respectively,which had certain value,and the value of combined prediction was higher.Conclusion The decrease of serum ADPN and the increase of HbA_(1)c in early DN patients are related to changes in renal function,and the application value of evaluating early DN is significant.
作者
许玉丹
张云
高双双
Xu Yudan;Zhang Yun;Gao Shuangshuang(Department of Laboratory Medicine,Nanyang Hospital of Traditional Chinese Medicine,Nanyang 473000,China)
出处
《实用医技杂志》
2025年第12期931-935,F0003,共6页
Journal of Practical Medical Techniques
关键词
糖尿病肾病
脂联素
糖化血红蛋白
Diabetic nephropathies
Adiponectin
Glycosylated hemoglobin
