尿外泌体二肽基肽酶4在糖尿病肾病早期诊断中的临床价值

The clinical value of urinary exosome dipeptidyl peptidase 4 in early diagnosis of diabetic nephropathy

目的:探讨尿外泌体二肽基肽酶4 (exosome-DPP4)在糖尿病肾病肾早期损伤中的诊断价值.方法:选取120例2型糖尿病患者,根据白蛋白肌酐比(UACR)分为A1组(40例)、 A2组(40例)和A3组(40例),另选健康对照组40例.酶联免疫吸附法(ELISA)检测尿外泌体DPP4,同时检测Cys C、肌酐(CREA)、尿素(UREA).应用方差分析及pearson相关分析DPP4与Cys C、 UACR、 CREA、 UREA相关性.结果:与对照组相比,尿外泌体DDP4水平在A1组就开始升高(P<0.05),且各组两两比较差异均有统计学意义;Cys C水平在A1组就升高,但与对照组相比无显著性差异(P>0.05), A2、 A3组显著高于对照组;UREA、 CREA在A3组显著升高(P<0.01),但A1、 A2组与对照组相比无显著性差异(P>0.05).尿外泌体DDP4与Cys C、 UACR、 CREA、 UREA呈正相关(r=0.711、 0.705、 0.469、 0.389).结论: DPP4水平与糖尿病肾病病情密切相关, DPP4检测对于糖尿病肾病的早期诊断及预后具有较高的临床价值.

Objective: To investigate the diagnostic value of exosome-DPP4 in early renal injury of diabetic nephropathy. Methods:120 patients with type 2 diabetes mellitus were divided into A1 group (40 cases), A2 group (40 cases) and A3 group (40 cases) according to the ratio of albumin to creatinine ( UACR), and 40 cases of healthy control group. DPP4 in urine was detected by enzyme-linked immunosorbent assay (ELISA). Cys C, creatinine (CREA) and urea (UREA) were also detected. The correlation between DPP4 and Cys C, UACR, CREA and UREA was analyzed by Pearson correlation analysis and variance analysis. Results: Compared with the control group, the level of DDP4 in urinary exosome began to increase in group A1 (P<0.05), and there were significant differences between the two groups. Cys C level increased in group A1, but there was no significant difference compared with the control group (P>0.05), A2 and A3 groups were significantly higher than the control group. UREA and CREA were significantly higher in group A3 (P<0.01), but there was no significant difference between group A1 and A2 and the control group (P>0.05). DDP4 was positively correlated with Cys C, UACR, CREA and UREA (r =0.711, 0.705, 0.469, 0.389). Conclusion: The level of DPP4 is closely related to the condition of diabetic nephropathy. The detection of DPP4 has high clinical value for the early diagnosis and prognosis of diabetic nephropathy.