2型糖尿病患者尿液中血管细胞黏附分子-1水平与肾脏损伤的相关性研究

Correlation study between urinary vascular cell adhesion molecule-1 levels and kidney injury in type 2 diabetes mellitus patients

目的探讨2型糖尿病患者尿液中血管细胞黏附分子-1(VCAM-1)水平与肾脏损伤的相关性及其临床意义。方法选取117例2型糖尿病患者和25例健康体检者(正常对照组),检测尿VCAM-1、尿微量白蛋白、血清肌酐的水平,计算糖尿病患者的肾小球滤过率(e GFR)。分析尿液VCAM-1与尿微量白蛋白、e GFR的相关性,ROC曲线评价VCAM-1在评估2型糖尿病患者肾脏损伤中的临床意义。结果糖尿病患者的VCAM-1水平高于正常对照组,差异有统计学意义(P<0.01);VCAM-1水平与e GFR呈负相关(r=-0.809,P<0.01);VCAM-1与尿微量白蛋白及血清肌酐均呈正相关(r值分别为0.812、0.758,P<0.01);VCAM-1诊断糖尿病肾病的AUC为0.951,临界值为38.26 ng/ml。结论检测糖尿病患者尿液VCAM-1水平对疾病诊断及病情判断具有一定的参考价值。

Objective To investigate the relationship between the levels of vascular cell adhesion molecule - 1 （ VCAM - 1 ） and renal injury in patients with type 2 diabetes mellitus and its clinical significance. Methods Urinary VCAM - 1, urinary albu- min, serum creatinine levels of 117 patients with type 2 diabetes and 25 cases of healthy persons（ control group） were detected. The glomerular filtration rate（eGFR） in diabetic patients was calculated, and its correlation between urinary ~CAM - 1 and uri- nary albumin and eGFR was performed. ROC curve was used to evaluate the clinical significance of VCAM - 1 in patients with type 2 diabetes mellitus. Results The levels of VCAM - 1 in patients with diabetes were significantly higher than control group, with the difference statistically significant（ P 〈0.01 ）. VCAM -1 levels and eGFR showed a significant negative correla- tion（r = -0. 809, P 〈0. O1 ）. VCAM -1 had a positive correlation with urinary albumin and serum creatinine（r =0. 812, 0. 758, P 〈 0.01 ）. AUC of VCAM - 1 was O. 951 in the diagnosis of diabetic nephropathy, and the critical value was 38.26 ng/ml. Conclusion Detection of urine VCAM - 1 level has certain reference value to the diagnosis and the condition of diabetic nephropathy.