β痕迹蛋白在老年糖尿病患者肾损害评估中应用的观察

The role of serum β trace protein in the elderly diabetic patients with renal injury

目的探讨血清β痕迹蛋白(βTP)在老年T2DM肾损害中应用价值。方法将131例老年T2DM患者分为尿白蛋白正常(NUAlb)组,微量尿白蛋白(MUAlb)组和大量尿白蛋白(CUAlb)组,另设健康对照(NC)组40名。采用胶乳增强散射免疫比浊法检测血清βTP,并与血肌酐(Scr)、胱抑素C(CysC),评估肾小球滤过率(eGFR)等指标进行相关性分析。结果 NUAlb组血清βTP水平高于NC组(P<0.05)。NUAlb组、MUAlb组、CUAlb组血βTP、CysC、Scr阳性率分别为32.5%、30.0%、0.0%,64.0%、60.0%、12.0%和87.8%、90.2%、29.3%;3组血βTP、CysC阳性率均显著高于Scr,但βTP、CysC之间差异无统计学意义。相关分析表明,血βTP与CysC、Scr、病程、SBP及UA呈正相关,与eGFR呈负相关,与HbA1c、FPG、DBP、BMI不相关。结论血清βTP对老年T2DM肾损害评价有一定意义,其诊断敏感性优于Scr,有可能成为评价肾小球滤过率新的血清学标志物。

Objective To study the role of serum 3 trace protein （βiP） in the evaluation of renal injury in elderly T2DNL Methods The 131 old patients with T2DM were classified into three groups： normal albuminuria group （NUAlb）, microalbuminuria group （MUAlb）, and macroalbuminuria group （CUAlb）. Forty healthy subjects were in the normal control group （NC）. Serum βTP were measured by using latex particle enhanced immunoturbidimetry assay. The correlations of serum βTP with serum creatinine （Scr）, cystatin C （CysC）, and the estinlated glomerular filtration rate （eC-FR） were analyzed. Results The level of serum βTP was significantly higher in the NUAlb group than in the NC group （P〈 0. 05）. The positive rates of serum βTP, CysC, and Scr were .32.5%, 30. 0%, and 0. 0% in the NUAlb group, 64.0%, 60.0%, and 12.0% in the MUAIb group, and 87.8%, 90.2%, and 29.3% in the CUAlb group respectively. The positive rates of serum βTP and CysC of the three groups were all significantly higher than that of Scr, while there was no significant difference between the positive rates of serum fliP and CysC. The correlation analysis showed that the serum βTP was positively correlated with the serum CysC, Scr, course of the disease, systolic blood pressure （SBP）, and serum uric acid （UA）, negatively correlated with eGFR, however, not correlated with HbA1c, fasting glucose （FPG）, diastolic blood pressure （DBP）, and body mass index （BMI）. Conclusion Serum βTP may be useful in evaluation of early renal injury of elderly T2DM and is superior to Scr in diagnostic sensitivity. It may be a new serological index in evaluating GFR.