血清Apelin、Chemerin及Fetuin-A联合检测用于糖尿病肾病早期诊断的敏感度与特异度分析

Sensitivity and specificity analysis of serum Apelin,Chemerin and Fetuin-A in diagnosis of early diabetic nephropathy

目的探讨血清Apelin、Chemerin及胎球蛋白A(Fetuin-A)联合检测在糖尿病肾病(diabetic nephropathy,DN)早期诊断中的价值。方法糖尿病患者132例,依据患者尿蛋白肌酐比率(urinary clbumin cretinine ratio,UACR)将患者分为DN组(UACR≥30 g/mg,84例)和非DN组(UACR<30 g/mg,48例),另选取同期体检健康者40例作为对照组,取血测定血清Apelin、Chemerin及Fetuin-A水平,分析血清Apelin、Chemerin及Fetuin-A联合检测诊断DN的敏感度与特异度。结果 DN组血清Apelin、Chemerin、Fetuin-A水平显著高于非DN组和对照组,非DN组Apelin、Fetuin-A显著高于对照组,差异均有统计学意义(P<0.05)。单独Apelin诊断DN的敏感度和阴性预测值最高,单独Chemerin诊断DN的特异度、准确度、阳性预测值最高。Apelin+Chemerin+Fetuin-A平行联合诊断的敏感度、准确度和阴性预测值最高;Apelin+Chemerin+Fetuin-A系列联合诊断的特异度、阳性预测值最高。结论单独血清Apelin、Chemerin、Fetuin-A诊断DN的敏感度和特异度均较低,联合诊断效能更佳,其中平行联合检测有助于提高DN诊断的敏感度,系列联合检测有助于提高DN诊断的特异度,联合检测对于DN早期诊断具有重要意义。

Objective To explore the value of serum Apelin,Chemerin and Fetuin-A in early diagnosis of diabetic nephropathy(DN).Methods The 132 patients with diabetes mellitus admitted were divided into DN group(UACR≥30 g/mg,84 cases)and Non-DN group(UACR<30 g/mg,48 cases)according to the patient′s UACR,and 40 healthy people in our hospital were selected as the control group.Serum Apelin,Chemerin and Fetuin-A levels were measured,and the sensitivity and specificity analysis of serum Apelin,Chemerin combined with Fetuin-A in diagnosis of early diabetic nephropathy were analyzed.Results The levels of Apelin,Chemerin and Fetuin-A in DN group were significantly higher than non-DN group and control group(P<0.05).The levels of Apelin and Fetuin-A in non-DN group were significantly higher than control group(P<0.05).The sensitivity and negative predictive value of Apelin to diagnose DN alone were the highest.The specificity,accuracy and positive predictive value of Chemerin to diagnose DN alone were the highest.The sensitivity,accuracy and negative predictive value of Apelin,Chemerin combined with Fetuin-A to diagnose DN parallelly were the highest,and the specificity and positive predictive value of o diagnose DN seriesly were the highest.Conclusion The sensitivity and specificity of Apelin,Chemerin and Fetuin-A to diagnose DN alone were lower,and the diagnostic efficiency of joint diagnosis was better.In parallelly,the combined detection could help to improve the sensitivity of DN diagnosis,among them,the combined detection could help to improve DN diagnosis specificity,which is important for the early diagnosis of DN.