血清Sema3a、25(OH)D与T2DM患者早期肾损伤的相关性研究

Correlation between serum Sema3a,25(OH)D and early renal injury in patients with T2DM

目的分析血清信号素3a(Sema3a)、25羟维生素D[25(OH)D]水平与2型糖尿病(T2DM)患者早期肾损伤的相关性。方法选取2020年7月至2021年12月该院T2DM患者287例,根据是否发生肾脏损伤分为肾损伤组(n=113)、肾功能正常组(n=174),检测血清Sema3a、25(OH)D,收集一般资料进行两组间比较,分析早期肾损伤的影响因素,早期肾损伤者血清Sema3a、25(OH)D水平与U-mAlb/Cr相关性,Pearson分析早期肾损伤者血清Sema3a、25(OH)D水平与U-mAlb/Cr相关性,并分析血清Sema3a、25(OH)D对预测T2DM患者早期肾损伤的价值。结果肾损伤组血糖控制情况较差,合并高血压率更高,血清TG、Cys-C、Scr、BUN、β2-MG、Sema3a水平高于肾功能正常组,血清25(OH)D水平低于肾功能正常组,糖尿病病程较肾功能正常组长(P<0.05);Logistic回归分析显示,U-mAlb/Cr、Sema3a、25(OH)D是T2DM患者早期肾损伤的独立影响因素(P<0.05);T2DM早期肾损伤患者Sema3a与U-mAlb/Cr呈正相关,25(OH)D与U-mAlb/Cr呈正相关(P<0.05);ROC曲线显示,Sema3a、25(OH)D联合预测T2DM患者早期肾损伤的AUC值为0.960,高于单独预测(P<0.05)。结论T2DM患者血清Sema3a升高、25(OH)D降低可显著增加早期肾损伤风险,早期持续监测血清Sema3a、25(OH)D水平可指导早期肾损伤风险评估与预防。

Objective To analyze the correlation between serum semaphore 3a(Sema3a)and 25-hydroxyvitamin D[25(OH)D]levels and early renal injury in patients with type 2 diabetes mellitus(T2DM).Methods A total of 287 patients with T2DM in the hospital from July 2020 to December 2021 were selected and divided into renal injury group(n=113)and normal renal function group(n=174)according to whether renal injury occurred.Serum Sema3a,25(OH)D,collect general data for comparison between the two groups,analyze the influencing factors of early renal injury,the correlation between serum Sema3a,25(OH)D levels and U-mAlb/Cr in patients with early renal injury,Pearson analysis of serum levels in patients with early renal injury The levels of Sema3a and 25(OH)D were correlated with U-mAlb/Cr,and the value of serum Sema3a and 25(OH)D in predicting early renal injury in T2DM patients was analyzed.Results The renal injury group had poorer blood sugar control,higher incidence of hypertension,higher serum levels of TG,Cys-C,Scr,BUN,β2-MG and Sema3a than normal renal function group,and lower serum 25(OH)D level.In the normal renal function group,the duration of diabetes was longer than that in the normal renal function group(P<0.05).Logistic regression analysis showed that U-mAlb/Cr,Sema3a,and 25(OH)D were independent influencing factors of early renal injury in T2DM patients(P<0.05);Sema3a was positively correlated with U-mAlb/Cr,and 25(OH)D was positively correlated with U-mAlb/Cr in patients with early renal injury in T2DM(P<0.05);ROC curve showed that the combined prediction of Sema3a and 25(OH)D The AUC value of early renal injury in T2DM patients was 0.960,which was higher than the prediction alone(P<0.05).Conclusion The increase of serum Sema3a and the decrease of 25(OH)D in T2DM patients can significantly increase the risk of early renal injury.Early continuous monitoring of serum Sema3a and 25(OH)D levels can guide the risk assessment and prevention of early renal injury.