T2DM患者尿α1酸性糖蛋白水平变化及与糖尿病肾病的关系

Urinary α1 acid glycoprotein levels and its relationship with diabetic nephropathy in T2DM patients

目的探讨尿α1酸性糖蛋白(AAG)对2型糖尿病(T2DM)患者发生糖尿病肾病(DN)的临床诊断价值。方法收集同期入院治疗的T2DM患者115例,根据Mogensen等分级标准正常白蛋白尿(NAU)组42例、微量白蛋白尿(MAU)组40例、大量白蛋白尿(MaAU)组33例,选择健康体检者(NC组)及呼吸系统感染性疾病患者(应激组)各40例,分别检测其尿AAG、血清AAG。结果 T2DM患者尿AAG水平显著高于NC组(P<0.05),且随24 h尿白蛋白排泄率(UAER)升高有上升趋势,NAU、MAU和MaAU各组间比较差异均有统计学意义(P均<0.05),但NAU组尿AAG水平与NC组比较差异无统计学意义;应激组血清AAG水平显著高于NC组(P<0.05),但两组尿AAG水平比较差异无统计学意义。结论尿AAG水平对于早期DN诊断及DN严重程度分级具有潜在应用价值。

Objective To investigate the diagnostic value of urinary oL1 acid glycoprotein （AAG）in type 2 diabetic （T2DM） patients with diabetic nephropathy（DN）. Methods Total of 115 patients with type 2 diabetes, 40 healthy sub-jects（ NC group） and 40 patients with infectious diseases（ stress group） were recruited, of which T2DM patients were fur-ther divided into 3 subgroups according to the classification standard of Mogensen： normal albuminuric（NAU） group 42 ca- ses, microalbuminuric（MAU） group of 40 cases and macroalbuminuric （MaAU）group of 33 cases. The urinary AAG and serum AAG were measured for all subjects. Results The level of urinary AAG in patients with T2DM was significantly higher than that in NC group （P 〈 0.05 ） , and which was positively correlated with UAER, the difference of urinary AAG between NAU, MAU and MaAU groups was statistically significant （ P 〈 0.05 ）, but there was no statistical significance be-tween NAU group and NC group. The level of serum AAG in stress group were significantly higher than thant in NC group （ P 〈 0.05 ）, but the level of urinary AAG between these two groups showed no statistical significance. Conclusion AAG in urine has potential application value for early diagnosis and staging of DN.