老年糖尿病患者血清Irisin和PEDF水平检测在早期肾损伤风险筛查中的应用价值

Application Value of Serum Irisin and PEDF in Screening Early Renal Injury Risk in Elderly Patients with Diabetes Mellitus

目的研究老年糖尿病患者血清鸢尾素(Irisin)、色素上皮衍生因子(pigment epithelium-derived factor,PEDF)在早期肾损伤风险筛查中的应用价值。方法收集2018年3月~2020年9月102例糖尿病患者,根据病情将102例患者分为A组(28例,单纯糖尿病)、B组[24例,早期糖尿病肾病(diabetic nephropathy,DN)]及C组(50例,临床DN)。比较三组血清Irisin和PEDF水平。根据肾小球滤过率(eGFR)是否<60ml/min·1.73 m^(2),记录肾损伤发生率。采用Cox风险回归模型分析糖尿病肾损伤的独立影响因素,以受试者工作曲线(receiver operating characteristic,ROC)分析血清Irisin,PEDF预测肾损伤的价值。结果A,B和C三组患者血清Irisin,PEDF水平比较,差异均有统计学意义(F=34.47,48.64,均P<0.05)。102例糖尿病患者中,30例发生肾损伤,发生率为29.41%。血清Irisin(95%CI=0.24~0.65,HR=0.40,P<0.01)、血清PEDF(95%CI=1.77~2.30,HR=2.02,P<0.01)是老年糖尿病早期肾损伤的独立影响因素。血清Irisin和PEDF联合检测判断老年糖尿病患者发生肾损伤风险的AUC为0.77(95%CI=0.66~0.88,P<0.01),敏感度和特异度分别为0.85和0.59。结论血清Irisin,PEDF参与老年糖尿病病理进程,血清Irisin与PEDF联合检测作为早期筛查老年糖尿病患者发生肾损伤风险的方法,敏感度高。

Objective To study the application value of serum Irisin and pigment epithelium-derived factor(PEDF)in screening early renal injury risk in elderly patients with diabetes mellitus.Methods There were 102 patients with diabetes mellitus from March 2018 to September 2020 were collected,102 patients were divided into group A(28 cases,simple diabetes),group B[24 cases,early diabetic nephropathy(DN)]and group C(50 cases,clinical DN),which accorded to the condition,the serum Irisin and PEDF levels were compared of the three groups.The incidence of renal injury was recorded,which accorded to whether the estimated glomerular filtration rate(eGFR)was<60 ml/min·1.73 m^(2)).The Cox risk regression model was used to analyze the independent influencing factors of diabetic kidney injury.The receiver operating characteristic(ROC)were used to analyze the value of serum Irisin and PEDF in predicting renal injury.Results There were significant differences in serum Irisin and PEDF levels between group A,group B and group C(F=34.47,48.64,all P<0.05).There were 30 cases of renal injury in 102 cases of diabetic patients,the incidence rate was 29.41%.The serum Irisin(95%CI=0.24~0.65,HR=0.40,P<0.01)and PEDF(95%CI=1.77~2.30,HR=2.02,P<0.01)were independent risk factors of early renal injury in elderly diabetic patients.The AUC of combined detection of serum Irisin and PEDF to determine the risk of renal injury in elderly diabetic patients was 0.77(95%CI=0.66~0.88,P<0.01),the sensitivity and specificity were 0.85 and 0.59 respectively.Conclusion The serum Irisin and PEDF are involved in the pathological process of senile diabetes mellitus,the combined detection of serum Irisin and PEDF have high sensitivity as an early screening method for renal injury risk in elderly diabetic patients.