几丁质酶1和热休克蛋白72对2型糖尿病肾病的早期诊断价值

Early diagnostic value of chitinase 1 and heat shock protein 72 in patients with type 2 diabetic nephropathy

目的探讨几丁质酶1和热休克蛋白72对2型糖尿病肾病的早期诊断价值。方法选取河南中医药大学第一附属医院2型糖尿病患者180例,根据24 h尿白蛋白排泄率(UAER)分为糖尿病无肾病组55例、早期糖尿病肾病组61例及临床糖尿病肾病组64例。另选取同期于该院体检的健康志愿者50例为健康对照组。比较各组受试者的血清几丁质酶1、热休克蛋白72及肾功能相关指标,并作指标间的相关性分析,并采用受试者操作特征(ROC)曲线分析几丁质酶1、热休克蛋白72对2型糖尿病肾病的早期诊断价值。结果糖尿病无肾病组、早期糖尿病肾病组、临床糖尿病肾病组血清几丁质酶1、热休克蛋白72、尿酸(UA)及糖化血红蛋白(HbA1c)水平均高于健康对照组(P<0.05),且糖尿病无肾病组、早期糖尿病肾病组、临床糖尿病肾病组的上述指标水平均呈逐渐上升趋势。几丁质酶1、热休克蛋白72与UA、HbA1c呈正相关(P<0.05)。几丁质酶1与热休克蛋白诊断2型糖尿病肾病的ROC曲线下面积(AUC)分别为0.762和0.815,敏感性和特异性均>0.7。结论2型糖尿病肾病血清几丁质酶1与热休克蛋白72水平升高,且与肾功能指标存在相关性,两者有助于2型糖尿病肾病的早期诊断。

Objective To explore the early diagnostic value of chitinase 1 and heat shock protein 72 in type 2 diabetic nephropathy.Methods According to the difference of the 24 h urinary albumin excretion rate(UAER),180 patients with type 2 diabetes mellitus were divided into diabetic without nephropathy group with 55 cases,early diabetic nephropathy group with 61 cases and clinical diabetic nephropathy group with 64 cases.Another 50 healthy volunteers who were underwent physical examination in our hospital at the same time were selected as healthy control group.The levels of serum chitinase 1,heat shock protein 72 and renal function related indexes in each group were compared,and the correlation among indexes was analyzed,and the early diagnostic value of chitinase 1 and heat shock protein 72 in type 2 diabetic nephropathy was analyzed by receiver operating characteristics(ROC)curve.Results The levels of serum chitinase 1,heat shock protein 72,uric acid(UA)and glycosylated hemoglobin(HbA1c)in diabetic without nephropathy group,early diabetic nephropathy group and clinical diabetic nephropathy group were higher than those in the healthy control group(P<0.05).The levels of the above indicators in diabetic without nephropathy group,early diabetic nephropathy group and clinical diabetic nephropathy group were all increasing gradually.Chitinase 1 and heat shock protein 72 were positively correlated with UA and HbA1c(all P<0.05).The ROC-AUC of chitinase-1 and heat shock protein were 0.762 and 0.815 respectively,and the sensitivity and specificity were above 0.7.Conclusions The levels of serum chitinase 1 and heat shock protein 72 in type 2 diabetic nephropathy are increase significantly,and they are correlation with renal function indexes.Both may contribute to early diagnosis of type 2 diabetic nephropathy.