糖尿病肾脏疾病患者血清游离轻链水平与肾功能指标的相关性研究

Serum free light chain level in patients with diabetic kidney disease and its correlation with renal function indexes

目的探讨糖尿病肾脏疾病(DKD)患者血清游离轻链水平及其与肾功能指标的相关性。方法回顾性分析2017年10月至2020年10月北京市第六医院120例DKD患者(研究组)和80例单纯糖尿病患者(糖尿病组)的临床资料。采集两组患者空腹外周静脉血5 ml,检测血清尿酸、肌酐、同型半胱氨酸(Hcy)和游离轻链(包括游离轻链κ、游离轻链λ、游离轻链κ与游离轻链λ比值和总游离轻链)水平,并计算估算肾小球滤过率(eGFR)。采用Pearson法分析DKD患者血清总游离轻链与肾功能指标的关系。结果DKD组游离轻链κ、游离轻链λ、游离轻链κ与游离轻链λ比值、总游离轻链、尿酸、肌酐和Hcy明显高于糖尿病组[(33.92±9.06)mg/L比(17.65±4.72)mg/L、(17.52±2.83)mg/L比(9.81±3.20)mg/L、1.93±0.23比1.80±0.25、(51.44±12.31)mg/L比(27.46±7.92)mg/L、(383.69±96.11)μmol/L比(345.93±93.94)μmol/L、(117.57±22.39)μmol/L比(75.06±14.73)μmol/L和(17.64±5.76)μmol/L比(11.66±5.46)μmol/L],eGFR明显低于糖尿病组[(103.95±22.58)ml/(min·1.73 m^(2))比(142.65±26.50)ml/(min·1.73 m^(2))],差异有统计学意义(P<0.01)。Pearson相关分析结果显示,DKD患者血清总游离轻链与血清尿酸、肌酐和Hcy呈正相关(r=0.707、0.709和0.820,P<0.01),与eGFR呈负相关(r=-0.730,P<0.01)。结论DKD患者血清游离轻链表达水平明显升高,与肾功能指标有一定的相关性,通过检测血清游离轻链表达水平能够反映肾损伤程度,可作为病情监测辅助的评估指标之一。

Objective To explore the correlation between the level of serum free light chain and renal function indexes in patients with diabetic kidney disease(DKD).Methods The clinical data of 120 patients with DKD(study group)and 80 patients with simple diabetes(diabetes group)in the Beijing Sixth Hospital from October 2017 to October 2020 were retrospectively analyzed.Five ml of fasting peripheral venous blood were collected,the levels of serum uric acid,creatinine,homocysteine(Hcy)and free light chain(including free light chainκ,free light chainλ,ratio of free light chainκand free light chainλand total free light chain)were detected,and the estimated glomerular filtration rate(eGFR)was calculated.The correlation between total free light chain and renal function indexes in patients with DKD was analysis by Pearson method.Results The free light chainκ,free light chainλ,ratio of free light chainκand free light chainλ,total free light chain,uric acid,creatinine and Hcy in DKD group were significantly higher than those in diabetes group:(33.92±9.06)mg/L vs.(17.65±4.72)mg/L,(17.52±2.83)mg/L vs.(9.81±3.20)mg/L,1.93±0.23 vs.1.80±0.25,(51.44±12.31)mg/L vs.(27.46±7.92)mg/L,(383.69±96.11)μmol/L vs.(345.93±93.94)μmol/L,(117.57±22.39)μmol/L vs.(75.06±14.73)μmol/L and(17.64±5.76)μmol/L vs.(11.66±5.46)μmol/L,the eGFR was significantly lower than that in diabetes group:(103.95±22.58)ml/(min·1.73 m2)vs.(142.65±26.50)ml/(min·1.73 m2),and there were statistical differences(P<0.01).Pearson correlation analysis results showed that serum total free light chain in patients with DKD was positively correlated with uric acid,creatinine and Hcy(r=0.707,0.709 and 0.820;P<0.01),and negatively correlated with eGFR(r=-0.730,P<0.01).Conclusions The expression level of serum free light chain is obviously increased in patients with DKD,it has a certain correlation with renal function indexes.It can be used as one of the evaluation indicators for disease monitoring.