尿转铁蛋白对糖尿病早期肾病检测的评价

Evaluation of Urinary Transferrin Testing in Detecting Early Diabetic Nephropathy

目的:评价即刻尿白蛋白浓度(UALB)、尿白蛋白/肌酐比(UALB/Cr)、尿转铁蛋白浓度(UTRF)、尿转铁蛋白/肌酐比(UTRF/Cr)对糖尿病早期肾病诊断的灵敏性和特异性。方法:对262例受试者(正常103例,糖耐量减低98例,糖尿病61例)测定尿白蛋白、尿转铁蛋白、尿肌酐;进行相关分析及ROC曲线分析。结果:UALB、UTRF、UTRF/Cr与UALB/Cr比较相关系数分别为:0.792、0.489、0.618。ROC曲线下面积分别为:0.889、0.788、0.842。当UTRF/Cr=0.112mg.mg-1时,对糖尿病早期肾病诊断的敏感性为96.1%,特异性为73.6%。UTRF/Cr的阳性率(41.6%)高于UALB/Cr的阳性率(29.7%)。结论:UTRF/Cr和UALB/Cr均可用于糖尿病早期肾病的筛查,UTRF/Cr的检出率高于UALB/Cr。

Objective： To assess the sensitivity and specificity of urine albumin concentration（UALB）, urinary albumin-to-Creatinine ratio（UALB/Cr）, urine transferrin concentration（UTRF） and urinary transferrin-to-Creatinine ratio（UTRF/Cr） in the diagnosis of early diabetic nephropathy. Methods：Two-hundred sixty-two subjects （103 normals;98 patients with impaired glucose tolerance;61 patients with diabetes） were examined for their urine albuminurine, transferrin and urine Creatinine. Then correlation analysis and ROC curve analysis were performed. Results： The correlation coefficient among the comparison of UALB, UTRF,UTRF/Cr with UALB/CR was 0. 792,0.487,0. 618 respectively. The areas under the ROC curves were 0.889,0.788,0.842 respectively. Sensitivity of detecting early diabetic nephropathy was 96.1 % while the specificity was 73.60% when UTRF/Cr was 0.112 mg/mg. The positive rate of UTRF/Cr（41.6%） was higher than the positive rate of UALB/Cr（29.7%）. Conclusion： UTRF/Cr and UALB/Cr can be used in the detection of early diabetic nephropathy. The detective rate of UTRF/Cr was higher than that of UALB/ Cr.