血清同型半胱氨酸、β2微球蛋白及视黄醇结合蛋白联合检测对2型糖尿病早期肾损害的诊断价值

Diagnostic value of serum homocysteine,beta 2 Microglobulin and retinol binding protein in early kidney damage from type 2 diabetes mellitus

目的探讨血清同型半胱氨酸(HCY)、β2微球蛋白(β2-MG)及视黄醇结合蛋白(RBP)联合检测对2型糖尿病(T2DM)早期肾损害的诊断价值。方法选择南海高新区人民医院2018年7月-2019年12月门诊和住院的2型糖尿病患者80例作为观察组,另选取同期体检的健康人群50例作为对照组。根据m Alb/Cr的比值将80例2型糖尿病患者分为2组,即单纯糖尿病组、早期糖尿病肾病组,对80例观察组和50名健康对照组同时进行血清HCY、β2-MG、RBP、肌酐、尿微量白蛋白五项目的平行检测,并作对比分析。结果对照组HCY、β2-MG、RBP水平低于单纯糖尿病组,差异有统计学意义(P <0.05)。单纯糖尿病组血清HCY、β2-MG、RBP以及m Alb/Cr水平低于早期糖尿病肾病组,差异具有统计意义(P <0.05)。血清HCY、β2-MG、RBP联合检测对早期T2DMN的诊断灵敏度、特异性、阴性预测值分别为94.00%、67.50%、94.74%。其中灵敏度、阴性预测值均比血清HCY、β2-MG、RBP单独检测高。结论 HCY、β2-MG、RBP联合检测可用于评判2型糖尿病的早期肾损害及其程度,对2型糖尿病肾病的早期诊断具有较高的临床诊断价值。

Objective To investigate the diagnostic value of serum homocysteine( HCY),beta 2 microglobulin( β2-MG) and retinol binding protein( RBP) in early renal damage from type 2 diabetes mellitus( T2 DM). Methods Eighty outpatients and inpatients with type 2 diabetes in the People’s Hospital of Nanhai Economic Development Zone from July 2018 to December 2019 were selected as the observation group,and 50 healthy people coming up for health examination at the same period as the control group. According to the m Alb/Cr ratio,80 patients with type 2 diabetes were divided into two groups: diabetes group and early diabetic nephropathy group. Parallel examinations of serum HCY,β2-MG,RBP,creatinine,urinary microalbumin five items were performed in the observation group and the healthy control group,with the acquired data comparatively analysed. Results The levels of HCY,β2-MG and RBP in the control group were significantly lower than those in the diabetes group( P < 0. 05). The levels of serum HCY,β2-MG,RBP,and m Alb/Cr ratio in the diabetes group were significantly lower than those in the early diabetic nephropathy group as well( P < 0. 05). The diagnostic sensitivity,specificity and negative predictive value of serum HCY,β2-MG and RBP for early T2 DMN were 94. 00%,67. 50% and 94. 74%,respectively. The sensitivity and negative predictive values were higher than the serum HCY,β2-MG,RBP alone. Conclusion The joint detection of HCY,β2-MG and RBP can be used to judge the early renal damage and the degree of type 2 diabetes mellitus,which has a high clinical diagnostic value for the early diagnosis of type 2 diabetic nephropathy.