尿肾损伤分子-1检测在糖尿病肾病早期诊断中的意义

Significance of urinary kidney injury molecule-1 detection in predicting the early diabetes nephropathy

目的探讨尿液肾损伤分子-1(KIM-1)对糖尿病肾病(DN)早期诊断的意义。方法根据尿微量白蛋白(MA)水平将120例Ⅱ型糖尿病患者分为尿MA正常组30例,尿MA少量组48例,尿MA大量组42例,同期健康体检者30例作为对照组,同时检测尿KIM-1、视黄醇结合蛋白(RBP)和β2-微球蛋白(β2-MG)水平,并分析所有研究对象血清相关指标。结果随着DN进展,尿KIM-1水平逐渐增高,且各组间差异有统计学意义(P<0.05);尿MA少量组、尿MA大量组尿MA、RBP和β2-MG均明显高于尿MA正常组和对照组(P<0.05)。血清BUN和Cr水平能反应肾脏的滤过功能,FBS和HbA1C可用于糖尿病诊断,但均不能早期提示肾小管损伤。各DM组HDL-C均明显低于对照组(P<0.05),而LDL-C则尿MA大量组高于尿MA正常组、尿MA正常组高于对照组(P<0.05)。结论尿KIM-1水平高低与损伤的严重程度呈正比,较早的反映Ⅱ型糖尿病肾损伤,可作为DN早期诊断指标。

Objective To investigate the value of kidney injury molecule-1（KIM-1）in predicting the early diabetes nephropathy（DN）.Methods A total of 120 patients with type Ⅱ diabetes were divided into three groups in our hospital according to urinary micro-albumin（MA）level：the normal MA group（30 cases）,the micro MA group（48 cases）,and the macro MA group（42 cases）,and 30 healthy subjects were selected as the control group.The levels of urinary KIM-1,MA,RBP andβ2-MG were detected of the four groups.At the same time,the levels of serum related indicators in all subjects were analyzed.Results With the progress of DN,urinary KIM-1 level gradually increased,with the differences statistically significant among the groups（P〈0.05）;MA,RBP and β2-MG of the micro MA group and the macro MA group were significantly higher than that in the normal MA group and the control group（P〈0.05）.BUN and Cr levels of serum can reflect the filtration function of the kidney,FBS and HA1 C can be used for the diagnosis of diabetes,but all can＇t predict early kidney injury.The HDL-C in all DM groups was significantly lower than that in the control group（P〈0.05）,while the LDL-C level in the macro MA group was significantly higher than that in the normal MA group,and that in the normal MA group was higher than that in the control group（P〈0.05）.Conclusion The level of urinary KIM-1 is directly proportional to the severity of injury.Earlier reflection of type 2 diabetic nephropathy can be used as an early indicator of DN.