HbA1c、BNP、uRBP、uTRF对早期糖尿病肾病的诊断价值

Diagnostic value of HbA1c,BNP,uRBP,uTRF in early diabetic nephropathy

目的探讨糖化血红蛋白(HbA1c)、脑钠肽(BNP)、尿视黄醇结合蛋白(uRBP)、尿转铁蛋白(uTRF)对早期糖尿病肾病(DN)的诊断价值。方法选取2017年5月至2020年5月该院收治的2型糖尿病患者104例为研究对象。根据尿清蛋白肌酐比值(UACR)将患者分为正常UACR组(UACR<30 mg/g)和UACR轻度升高组(UACR为30~300 mg/g),另选取同期体检健康者52例为对照组。检测研究对象HbA1c、BNP、uRBP、uTRF水平;采用受试者工作特征曲线(ROC曲线)分析4项指标单独及联合检测对早期DN的诊断价值。结果 UACR轻度升高组UACR、HbA1c、BNP、uRBP、uTRF水平高于正常UACR组和对照组,正常UACR组UACR、HbA1c、BNP、uRBP、uTRF水平高于对照组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,HbA1c、BNP、uRBP、uTRF诊断早期DN的曲线下面积(AUC)分别为0.705、0.822、0.794、0.792。4项联合检测诊断的AUC为0.951,高于HbA1c、BNP、uRBP、uTRF单独检测。结论 HbA1c、BNP、uRBP、uTRF联合检测对早期DN具有较高的诊断价值,可用于指导临床诊断。

Objective To explore the diagnostic value of glycosylated hemoglobin(HbA1 c),brain natriuretic peptide(BNP),urinary retinol binding protein(uRBP) and urinary transferrin(uTRF) for early diabetic nephropathy(DN).Methods A total of 104 patients with type 2 diabetes who were admitted to the hospital from May 2017 to May 2020 were selected as the research objects.According to the urine albumin-creatinine ratio(UACR),patients were divided into normal UACR group(UACR<30 mg/g) and mildly elevated UACR group(UACR 30-300 mg/g).In addition, 52 healthy people took physical examination during the same period were selected as the control group.The levels of HbA1 c, BNP,uRBP and uTRF of all the subjects were detected.Receiver operating characteristic curve(ROC curve) was used to analyze the diagnostic value of 4 indicators individually and in combination for early DN.Results The levels of UACR,HbA1 c, BNP,uRBP and uTRF in the mildly elevated UACR group were higher than those in the normal UACR group and control group, the levels of UACR,HbA1 c, BNP,uRBP and uTRF in the normal UACR group were higher than those in the control group, and the differences were statistically significant(P<0.05).ROC curve analysis results showed that the area under the curve(AUC) of HbA1 c, BNP,uRBP and uTRF in the diagnosis of early DN were 0.705,0.822,0.794,0.792 respectively.The AUC of the 4 indicators combined detection was 0.951,which was higher than that of HbA1 c, BNP,uRBP and uTRF alone.Conclusion The combined detection of HbA1 c, BNP,uRBP and uTRF has high diagnostic value for early DN and can be used to guide clinical diagnosis.