血清dp-ucMGP、BGP水平与2型糖尿病肾脏病变的相关性及预测价值

Correlation and predictive value of serum dp-ucMGP and BGP levels in type 2 diabetic kidney disease

目的探讨去磷酸-未羧化基质GLA蛋白(dp-ucMGP)、骨钙素(BGP)水平与2型糖尿病肾脏病变(DKD)的相关性及预测价值。方法收集2020年9月~2021年11月在我院内分泌科住院的138例2型糖尿病(T2DM)患者,以尿微量白蛋白/肌酐(ACR)水平分组:ACR<3 mg/mmol为单纯糖尿病组(DM,n=56);ACR在3~30 mg/mmol为早期糖尿病肾脏病变组(eDKD,n=38);ACR>30 mg/mmol为临床糖尿病肾病组(cDKD,n=44);检测患者血中dp-ucMGP、BGP及临床生化指标。结果与DM组相比,eDKD组和cDKD组患者的dp-ucMGP升高,BGP降低(均P<0.05)。Spearman相关性分析结果显示dp-ucMGP与CRE、UREA、ACR水平呈正相关,与eGFR呈负相关(均P<0.05);BGP与ACR呈负相关(P<0.05);Logistic回归提示dp-ucMGP是DKD的危险因素,BGP是DKD的保护性因素。通过ROC曲线分析确定两者联合诊断DKD的敏感性0.781,特异性0.750,AUC是0.838(95%CI:0.773~0.902)。结论dp-ucMGP是DKD的危险因素,BGP是DKD保护因素,两者可能对DKD的诊断具有一定价值。

Objective To investigate the correlation and predictive value of dp-ucMGP and BGP levels with type 2 diabetic kidney disease(DKD),and provide a new conception for the diagnosis of DKD.Methods A total of 138 patients with type 2 diabetes mellitus were collected from December 2020 to October 2021 who were admitted to the endocrinology department of our hospital.According to the urinary microalbumin/creatinine(ACR)level.The patients with ACR<3mg/mmol were divided into plain diabetes group(DM,n=56),ACR between 330 mg/mmol was in the early diabetic kidney disease group(eDKD,n=38),ACR>30mg/mmol was classified as clinical diabetic kidney disease group(cDKD,n=44).dp-ucMGP,BGP levels and other clinical biochemical indexes were inspected.Results In contrast to DM group,dp-ucMGP in eDKD group and cDKD group was increased,while BGP was decreased(P<0.05).Spearman correlation analysis showed that dp-ucMGP was positively correlated with ACR,CRE,UREA levels,and negatively correlated with eGFR.BGP was negatively correlated with ACR.Logistic regression demonstrated that dp-ucMGP was a risk factor for DKD,and BGP was a protective factor.The sensitivity of the combined diagnosis of DKD was 0.781,the specificity 0.750,and the AUC was 0.838(95%CI:0.773-0.902)as determined by ROC curve analysis.Conclusion Dp-ucMGP is a risk factor of DKD,BGP is a protective factor of DKD,both of them have certain value for the diagnosis of DKD.