NEFA、ALB、BMG和CREA在2型糖尿病肾病中的临床诊断价值

Clinical diagnosis value of NEFA,ALB,BMG and CREA in patient with type 2 diabetic nephropathy

目的探讨血清游离脂肪酸(NEFA)、肌酐(CREA)、清蛋白(ALB)、β2微球蛋白(BMG)在2型糖尿病肾病(T2DN)中的临床应用价值。方法选取2016年10月至2017年2月该院2型糖尿病(T2DM)患者140例,根据尿蛋白及尿微量清蛋白检测结果将其分为T2DM非肾病组(47例)和T2DN组(93例),根据血清ALB检测结果将T2DN组进一步分为ALB高值亚组(ALB>30g/L,47例)和ALB低值亚组(ALB≤30g/L,46例),同时选取健康体检者51例作为健康对照组,检测各组NEFA、ALB、CREA、BMG、NEFA/ALB水平,并分析各指标间相关性。结果 T2DM非肾病组NEFA、NEFA/ALB水平明显高于健康对照组,差异有统计学意义(P<0.05)。T2DN组NEFA水平明显高于健康对照组,NEFA/ALB、BMG、CREA水平高于健康对照组和T2DM非肾病组,而ALB水平明显低于健康对照组和T2DM非肾病组,差异有统计学意义(P<0.05)。ALB高值亚组和ALB低值亚组BMG、CREA水平明显高于T2DM非肾病组,差异有统计学意义(P<0.05);ALB低值亚组NEFA、ALB水平明显低于T2DM非肾病组和ALB高值亚组,而NEFA/ALB水平明显高于T2DM非肾病组,差异有统计学意义(P<0.05)。ALB水平与NEFA水平呈明显正相关(r=0.252,P<0.01),与BMG、CREA水平呈明显负相关(r值分别为-0.424、-0.281,P<0.01);BMG水平与CREA水平呈明显正相关(r=0.920,P<0.01)。结论血清BMG、CREA、NEFA和ALB在T2DM病程进展中起着重要作用,可以作为评估T2DM肾脏损伤程度的监测指标。

Objective To investigate the clinical application value of serum non-esterified fatty acid(NEFA),albumin(ALB),creatinine(CREA)andβ2-microglobulin(BMG)levels in type2diabetic nephropathy(T2DN).Methods140cases of type2diabetes mellitus(T2DM)in this hospital from October2016to February2017were selected and divided into the T2DM non-nephropathy group(47cases)and T2DN group(93cases)according to urinary albumin and urinary microalbumin.The T2DN group was further divided into the ALB high value subgroup(ALB>30g/L,47cases)and ALB low value subgroup(ALB≤30g/L,46cases)according to serum ALB detection results.Meanwhile51persons undergoing healthy physical examination were selected as the healthy control group.The levels of NEFA,ALB,CREA and BMG were measured in each group.Then the correlation among groups was analyzed.Results The levels of serum NEFA and NEFA/ALB in the T2DM non-nephropathy group were significantly higher than those in the healthy control group,the difference was statistically significant(P<0.05).The serum NEFA level in the T2DN group was significantly higher than that in the healthy control group,and the levels of NEFA/ALB,BMG and CREA were higher than those in the healthy control group and T2DM non nephrotic group,while the ALB level was significantly lower than that in the healthy control group and T2DM non nephropathy group,the difference was statistically significant(P<0.05).The levels of BMG and CREA in the ALB high value subgroup and ALB low value subgroup were significantly higher than those in the T2DM non-nephropathy group,the difference was statistically significant(P<0.05);the levels of NEFA and ALB in the ALB low value subgroup were significantly lower than those in the T2DM non-nephropathy group and ALB high value subgroup,while the NEFA/ALB levels were significantly higher than those in the T2DM non-nephropathy group,the difference was statistically significant(P<0.05).The ALB was positively correlated with NEFA level(r=0.252,P<0.01),and was negatively correlated with BMG and CREA levels(r=-0.424,r=-0.281,P<0.01);serum BMG level was positively correlated with serum CREA level(r=0.920,P<0.01).Conclusion Serum BMG,CREA,NEFA and ALB play an important role in progress of T2DN,and can serve as the monitoring indicators of renal injury degree in T2DM.