青年高尿酸血症患者尿中中性粒细胞明胶酶相关脂质运载蛋白和肾损伤分子-1水平及影响因素分析

Levels of urine neutrophil gelatinase-associated lipocalin and kidney injury molecule 1 and its relevant influencing factors in young patients with hyperuricemia

目的 探讨青年高尿酸血症患者尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和肾损伤分子-1（KIM-1）水平及其影响因素.方法 采用随机数字表法选取体检发现的青年原发性高尿酸血症患者60例（高尿酸血症组）,同法随机选取60名血尿酸水平正常的青年体检者（对照组）.测定尿NGAL、KIM-1水平及相关生化指标等;采用t检验或方差分析分析2组患者临床相关资料生化指标等,一元线性回归分析上述指标与尿NGAL/肌酐和KIM-1/肌酐值的关系,多元线性回归分析影响尿NGAL/肌酐和KIM-1/肌酐值的相关因素.结果 高尿酸血症组患者尿NGAL/肌酐值[（10.5±3.1） ng/mg肌酐]和KIM-1/肌酐值[（2.48±0.51） ng/mg肌酐]均较对照组明显增高[（1.5±0.8）rg/mg肌酐,（0.80±0.13） ng/mg肌酐,t值分别为22.152 5,24.725 5,P＜0.01].一元线性回归分析显示血尿酸水平与尿NGAL肌酐和KIM-1/肌酐值均呈正相关（r=0.63,P＜0.01;r=0.41,P＜0.01）.多元线性回归分析显示血尿酸、收缩压、糖化血红蛋白（HbA1c）、血肌酐和胆固醇水平是NGAL肌酐值的独立影响因素,年龄、血尿酸,收缩压、HbA1c和血肌酐水平是KIM-1/肌酐值的独立影响因素.结论 高尿酸血症人群尿NGAL/肌酐值和KIM-1/肌酐值增高,高尿酸血症、高收缩压、糖尿病、肾功能下降和高胆固醇血症是尿NGAL/肌酐值增高的独立影响因素,较大年龄、高尿酸血症、高收缩压、糖尿病和肾功能下降是尿KIM-1/肌酐值增高的独立影响因素.

Objective To investigate urine levels of neutrophil gelatinase-associated lipocalin （NGAL） and kidney injury molecule 1（KIM-1）, and its relevant influencing factors in young patients with hyperuricemia.Methods Sixty young subjects with hyperuricemia were randomly selected from physical check-up examination population （the hyperuricemic group）, and 60 young subjects with normouricemia were randomly selected at the same time from physical check populationexamination （the control group）.Urine NGAL and KIM-1, and other biochemical indicators were evaluated.Clinical data, iab tests, testing items and biochemical indicators between the two groups were analyzed by using t test or analysis of variance test.Regression analysis between the above indicators and urinary NGAL/creatinine （cr） and urine KIM-1/cr ratios were carried by using single regression analysis.Analyzed relevant Relevant influencing factors of urinary NGAL/cr and urine KIM-1/cr ratios were analyzed by using multiple linear regression.Results Urine NGAL/cr and urine KIM-1/cr ratios in the hyperuricemic group were higher than the control group （t=22.152 5, t=24.725 5, P〈0.01）.Single regression analysis showed that serum uric acid level and urine NGAL/cr ratio, KIM-1/cr ratio was positively correlations correlated （r=0.63, P〈0.01;r=0.41, P〈0.01）.Multiple linear regression analysises showed that serum uric acid,systolic blood pressure, HbA1c, serum creatinin and cholesterol level were the independent factors of urine NGAI/cr ratio.Age, blood uric acid level, systolic blood pressure, HbA1c and serum creatinin levels were independent factors of KIM-1/cr ratio.Conclusion There are high levels in of urine NGAL/cr and KIM-1/cr ratios in population with hyperuricemia.Hyperuricemia, high systolic pressure, diabetes mellitus, declined kidney function and hypercholesterolemia are independent factors of urine high NGAL/creatinin ratio.Oldage,hyperuricemia, high systolic pressure, diabetes mellitus and declined kidney function are independent factors of high urine KIM-1/cr ratio.