血清NRG-4水平对2型糖尿病患者肾损伤的诊断价值研究

Serum neuregulin-4 level in diagnosis of patients with type 2 diabetes mellitus and nephropathy

目的本研究旨在探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清神经调节蛋白-4(neuregulin-4,NRG-4)水平与肾损伤之间的关系。方法将2019年1月至2020年9月本院收治的124例T2DM患者作为研究对象,根据尿微量白蛋白排泄率(urine microalbumin excretion rate,UAER)分为T2DM组和糖尿病肾病(diabetes nephropathy,DN)组。采用ELISA法检测患者血清NRG-4含量,并分析其与糖尿病相关指标的相关性,使用ROC分析NRG-4对糖尿病肾病的诊断价值。结果T2DM组中男40例,女30例,年龄(54.2±3.9)岁,DN组中男30例,女24例,年龄(56.2±5.4)岁,两组患者一般资料比较,差异均无统计学意义(均P>0.05)。DN组血清NRG-4含量为(1.09±0.39)μg/ml,显著低于T2DM组的(2.84±0.67)μg/ml(P<0.01)。随着患者血清NRG-4含量的下降,UAER水平随之增加;血清NRG-4与空腹血糖(FBG)(r=-0.231,P=0.017)、糖化血红蛋白(HbA1c)(r=-0.312,P=0.013)和尿微量白蛋白(r=−0.277,P=0.009)均呈负相关。血清NRG-4诊断糖尿病肾病的最佳临界值为1.56μg/ml,敏感性为82.1%,特异性为64.0%。结论DN患者的血清NRG-4水平较单纯糖尿病患者下降,与DN发生存在显著相关性,可用于辅助糖尿病肾损伤的诊断,具有一定的临床应用价值。

Objective To investigate the relationship between serum neuregulin-4(NRG-4)level and nephropathy in patients with type 2 diabetes mellitus(T2DM).Methods One hundred and twenty-four patients with T2DM treated at our hospital from January,2019 to September,2020 were divided into a T2DM group and a diabetic nephropathy(DN)group according to their urine microalbumin excretion rates(UAER).The serum NRG-4 level was detected by ELISA,and its correlation with diabetes related indicators was analyzed.ROC curve was used to analyze the diagnostic value of NRG-4 for DN.Results There were 40 males and 30 females in the T2DM group;they were(54.2±3.9)years old.There were 30 males and 24 females in the DN group;they were(56.2±5.4)years old.There were no statistical differences in the gender and age between the two groups(both P>0.05).The level of serum NRG-4 was lower in the DN group than in the T2DM group[(1.09±0.39)μg/L vs.(2.84±0.67)μg/L,P<0.01].As the serum NRG-4 level decreased,the UAER increased.The serum NRG-4 level was negatively correlated with FBG(r=-0.231,P=0.017),HbA1c(r=-0.312,P=0.013),and microalbuminuria(r=−0.277,P=0.009).The cut-off value of serum NRG-4 in diagnosing DN was 1.56 ng/ml;the sensitivity was 82.1%;and the specificity was 64.0%.Conclusions Serum NRG-4 level is lower in patients with DN than in those with only T2DM.Serum NRG-4 is correlated with the occurrence of DN.It can be used to assist the diagnosis of DN and has certain clinical application value.