血清25-(OH)D和α_(1)-MG与2型糖尿病肾病患者肾脏病理损伤程度相关性及对其诊断价值

Correlations between Serum Levels of 25-(OH)D and α_(1)-MG with Degree of Renal Pathological Injury in Patients with Type 2 Diabetic Nephropathy and Their Diagnostic Values

目的探讨血清25-羟维生素D[25-(OH)D]和α_(1)-微球蛋白(α_(1)-MG)与2型糖尿病肾病(DN)患者肾脏病理损伤程度相关性及对其诊断价值。方法选取2019年2月—2021年2月收治的2型DN 71例作为2型DN组,2型糖尿病41例作为2型糖尿病组。另选取同期健康体检者75例作为健康对照组。分析2型DN患者血清25-(OH)D和α_(1)-MG与肾脏病理损伤程度相关性;探讨2型DN发生影响因素;分析血清25-(OH)D、α_(1)-MG及二者联合对2型DN诊断价值。结果随着间质性纤维化和小管萎缩(IFTA)评分、间质炎症评分和肾小球分级增加,2型DN患者血清25-(OH)D呈下降趋势,血清α_(1)-MG呈升高趋势(P<0.01)。2型DN患者血清25-(OH)D与IFTA评分、间质炎症评分和肾小球分级呈负相关;血清α_(1)-MG与IFTA评分、间质炎症评分和肾小球分级呈正相关(P<0.01)。血清25-(OH)D和α_(1)-MG是2型DN发生的独立影响因素(P<0.01)。血清25-(OH)D、α_(1)-MG及二者联合诊断2型DN的曲线下面积分别为0.757、0.879和0.909。结论2型DN患者血清25-(OH)D和α_(1)-MG与肾脏病理损伤程度具有相关性,血清25-(OH)D和α_(1)-MG联合检测对2型DN的诊断价值较高。

Objective To investigate correlations of serum levels of 25 hydroxyvitamins D[25-(OH)D]andα_(1)-microglobulin(α_(1)-mg)with the degree of renal pathological injury in patients with type 2 diabetic nephropathy(DN)and their diagnostic values.Methods A total of 71 patients with type 2 DN admitted between February 2019 and February 2021 were selected as DN group,and other 41 patients with type 2 diabetes mellitus(T2DM)treated at the same period were selected as T2DM group.In addition,75 healthy subjects who had undergone physical examinations at the same period were selected as healthy control group.Correlations between serum 25-(OH)D andα_(1)-MG levels with the degree of renal pathological injury in patients with type 2 DN were analyzed.The influencing factors of type 2 DN were explored,and values of serum 25-(OH)D,α_(1)-MG and their combination in diagnosis of patients with type 2 DN were analyzed.Results Serum 25-(OH)D level was decreased,whileα_(1)-MG level was increased with increasing interstitial fibrosis and tubular atrophy(IFTA)score,interstitial inflammation score and glomerular grading in patients with type 2 DN(P<0.01).Serum 25-(OH)D level was negatively correlated with IFTA score,interstitial inflammation score and glomerular grading;serumα_(1)-MG was positively correlated with IFTA score,interstitial inflammation score and glomerular grading in patients with type 2 DN(P<0.01).Serum 25-(OH)D andα_(1)-MG were independent factors affecting the occurrence of type 2 DN(P<0.01).The areas under the curve of serum 25-(OH)D,α_(1)-MG and their combination in diagnosis of type 2 DN were 0.757,0.879 and 0.909 respectively.Conclusion Serum 25-(OH)D andα_(1)-MG are correlated with the degree of renal pathological injury,and combination of serum 25-(OH)D andα_(1)-MG has good value for diagnosis of patients with type 2 DN.