糖尿病肾病早期标志物研究新进展

Recent progress on the study of early marker for diabetic nephrophy

糖尿病肾病是造成终末期肾脏病的主要原因之一并导致糖尿病患者的死亡率不断增加。早期诊断和治疗是改善预后的关键。目前多用微量白蛋白尿和肾小球滤过率综合评价，但微量白蛋白尿的敏感性和特异性不强，肾小球滤过率在正常偏高水平时检测较为困难。因此，近几年很多研究致力于寻找检测糖尿病肾病和预测肾功能下降的早期标志物，包括足细胞标记蛋白、Wilms Tumor-1、胱抑素C、megalin和cubilin、肝脏脂肪酸结合蛋白、尿微小RNA、尿蛋白质组学、中性粒细胞趋化因子、维生素D结合蛋白、骨诱导因子和骨膜蛋白等。

Diabetic nephrophy（DN） constitutes one of the leading causes of end stage renal disease （ESRD） and accounts for a significant increase in morbidity in patients with diabetes. Early diagnosis and treatment is critical in improving patients＇ prognosis. Currently, the early screening of DN is based both on the level of urinary albumin excretion and glomerular filtration rate （GFR）. However, the sensitivity and specificity of mieroalbuminuria has been challenged, and high-normal level GFR is diffieult to be accurately measured. Consequently, great efforts have been made in recent years to identify early markers for the detec-tion of DN and progressive kidney function decline in diabetic patients, including podoealyxin, wilms tumor-I, cystatin C, megalin and cubilin, liver type fatty acid binding protein（L-FABP） , urine mieroRNAs, urine proteomics, monocyte chemoattractant protein-1 （MCP-1）, vitamin D-binding protein(VDBP）, osteoinduc-tire factor（OIF） and periostin,etc.