不同尿蛋白成分测定对早期糖尿病肾病的诊断价值

VALUE OF DETECTING DIFFERENT URINE PROTEINS IN THE DIAGNOSIS OF EARLY DIABETIC NEPHROPATHY

目的应用受试者工作曲线（ROC曲线）评价尿α1微球蛋白（α1-MG）、转铁蛋白（TRF）、β2微球蛋白（β2-MG）和免疫球蛋白G（IgG）的测定对早期糖尿病。肾病的诊断价值。方法2型糖尿病病人210例，根据尿微量清蛋白（m—Alb）与尿肌酐（Cr）比值分为正常蛋白尿组116例和微量清蛋白尿组94例，以110例健康体检者作为正常对照组。检测各组晨尿中in—Alb、αl—MG、TRF、β2-MG和IgG的含量。运用Pearson相关进行相关性分析，绘制ROC曲线并计算曲线下面积（AUC）。结果尿α1-MG、TRF和IgG与尿m—Alb水平呈显著正相关（r=0．325～0．461，P〈0．01），而尿β2-MG与尿m—Alb水平则无明显相关性（r=0．111，P〉0．05）。尿α1-MG、TRF和IgG诊断糖尿病肾病的AUC分别为0．721、0．865和0．849。结论尿a1～MG、TRF和IgG可作为糖尿病肾病的早期诊断标志物。

Objective To assess the diagnostic value of detecting urine αl microglobulin （αl-MG）, transferrin （TRF）, β2-microglobulin （β2-MG） and immunoglobulin G （IgG） in early diabetic nephropathy by using ROC curve. Methods This study consisted of 210 patients with type 2 diabetes mellitus （T2DM）, who were divided into normal urinary protein group （116 ca- ses）, and microalbuminuria group （94 cases） according to the ratio of urine m-Alb （microalbuminuria） and Ucr （urine creatinine） 110 healthy individuals served as normal controls. The levels of m-Alb, αl-MG, TRF, β2-MG, and IgG in morning urine samples of each group were measured. Pearson correlation was used to analyze the correlation, ROC curve was drew and the area under the curve （AUC）was calculated to evaluate the diagnostic value of each index. Results The urine αl-MG, TRF and IgG were posb tively correlated with m-Alb （r = 0.325-0.461, P 〈0.01）; and urine β2-MG was not obviously correlated with urine m-Alb （r = 0.111,P〈0.05）. When using urine β2-MG, TRF, 132-MG, and IgG to diagnose DN, the AUC of ROC curves was 0.721, 0.865, and 0.849, respectively. Conclusion The urine al-MG, TRF and lgG can be used as markers for early diagnosis of diabetic ne- phropathy.