血清Glypican-4因子对肥胖2型糖尿病患者合并糖尿病肾脏疾病的影响

Effect of serum Glypican-4 factor on diabetic kidney disease in obese patients with type 2 diabetic mellitus

目的探讨血清Glypican-4因子对肥胖2型糖尿病患者合并糖尿病肾脏疾病(DKD)的影响。方法选择2020年9月至2021年4月新疆医科大学第五附属医院诊治的128例肥胖2型糖尿病患者。依据《中国糖尿病肾脏病防治临床指南》将患者分为糖尿病组及DKD组。分析肥胖2型糖尿病患者合并DKD的影响因素;Spearman相关系数分析相关指标与尿白蛋白肌酐比值(UACR)、估算肾小球滤过率(eGFR)的相关性;Glypican-4因子对肥胖2型糖尿病患者合并DKD的诊断价值采用受试者操作特征曲线。结果两组高血压、病程、尿微量白蛋白、eGFR、UACR、血肌酐、甘油三酯(TG)、糖化血红蛋白(HBA1c)、空腹血糖(FBG)、餐后2 h血糖(2hPG)、Glypican-4比较,差异有统计学意义(P<0.05)。Glypican-4、FBG、2hPG、病程、高血压、TG是肥胖2型糖尿病患者合并DKD的影响因素(OR>1,P<0.05)。Glypican-4、HBA1c、FBG、2hPG、病程、高血压、TG与UACR呈正相关(r>0,P<0.05),与eGFR呈负相关(r<0,P<0.05)。Glypican-4对肥胖2型糖尿病患者合并DKD的截断值为0.76 ng/ml,曲线下面积为0.693,敏感度为69.0%,特异度为65.7%。结论肥胖2型糖尿病患者血清Glypican-4因子与DKD存在相关性,Glypican-4为DKD相关危险因素,对DKD诊断有一定价值。

Objective To investigate the effect of serum Glypican-4 factor on diabetic kidney disease(DKD)in obese patients with type 2 diabetic mellitus.Methods A total of 128 obese patients with type 2 diabetes mellitus diagnosed and treated in Fifth Affiliated Hospital of Xinjiang Medical University from September 2020 to April 2021 were selected.According to the Chinese Clinical Guidelines for the Prevention and Treatment of Diabetic Kidney Disease,the patients were divided into diabetes group and DKD group.The influence factor of DKD in obese patients with type 2 diabetes mellitus were analyzed;Spearman correlation coefficient was used to analyze the correlation between related indexes and urinary albumin-creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR);the value of Glypican-4 factor in the diagnosis of DKD in obese patients with type 2 diabetes mellitus was determined by receiver operating characteristic curve.Results There were significant differences in hypertension,course of disease,urinary microalbumin,eGFR,UACR,serum creatinine,triglyceride(TG),glycosylated hemoglobin(HBA1c),fasting blood glucose(FBG),2h postprandial blood glucose(2hPG),and Glypican-4 between two groups(P<0.05).Glypican-4,FBG,2hPG,course of disease,hypertension,and TG were the influencing factors of DKD in obese patients with type 2 diabetes mellitus(OR>1,P<0.05).Glypican-4,HBA1c,FBG,2hPG,course of disease,hypertension,and TG were positively correlated with UACR(r>0,P<0.05),and negatively correlated with eGFR(r<0,P<0.05).The cut-off value of Glypican-4 for DKD in obese patients with type 2 diabetes mellitus was 0.76 ng/ml,the area under the curve was 0.693,the sensitivity was 69.0%,and the specificity was 65.7%.Conclusion There is a correlation between serum Glypican-4 and DKD in obese patients with type 2 diabetes mellitus.Glypican-4 is a risk factor for DKD and has certain value in the diagnosis of DKD.