多指标单独及联合检测对早期糖尿病肾病的诊断价值

Diagnostic Value of Single and Combined Detection of Multiple Indicators in Early Diabetes Nephropathy

目的探讨糖化白蛋白(GA)、糖化血红蛋白(GHb,结果以HbA1c表示)、胱抑素及尿五蛋白[转铁蛋白(TRF)、α1微球蛋白(α_(1)-MG)、免疫球蛋白G(IgG)、β_(2)-微球蛋白(β_(2)-MG)、微量白蛋白(mAlb)]单独及联合检测对早期糖尿病肾病的诊断价值。方法选取2020年9月至2022年9月医院收治的120例2型糖尿病患者作为研究对象,根据是否合并早期糖尿病肾病分为早期糖尿病肾病组(41例)和单纯糖尿病组(79例)。比较两组GA、HbA1c、胱抑素及尿五蛋白水平,分析以上指标与早期糖尿病肾病的相关性,并绘制ROC曲线分析以上指标单独及联合检测对早期糖尿病肾病的诊断价值。结果早期糖尿病肾病组的GA、HbA1c、胱抑素及尿五蛋白水平均高于单纯糖尿病组,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,GA、HbA1c、胱抑素及尿五蛋白水平与早期糖尿病肾病呈正相关(P<0.05);ROC分析结果显示,GA、HbA1c、胱抑素及尿五蛋白水平诊断早期糖尿病肾病的曲线下面积(AUC)分别为0.860、0.790、0.745、0.932、0.868、0.747、0.858、0.885,而联合检测的AUC为0.994。结论GA、HbA1c、胱抑素及尿五蛋白均对早期糖尿病肾病有一定的诊断价值,且联合检测的诊断准确性高于各指标单独检测。

Objective To investigate the diagnostic value of glycated albumin(GA),glycated hemoglobin(HbA1c),cystatin and urinary pentaprotein[transferrin(TRF),α1 microglobulin(α1-mg),immunoglobulin G(IgG),β_(2)-microglobulin(β_(2)-MG),microalbumin(mAlb)]alone and in combination for early diabetic nephropathy.Methods With the selection of 120 patients with type 2 diabetes admitted to the hospital from September 2020 to September 2022 as the research objects,patients were divided into early diabetes nephropathy group(41 cases)and simple diabetes group(79 cases)according to whether they were associated with early diabetes nephropathy or not.The levels of GA,HbA1c,cystatin and urinary pentaprotein in the two groups were compared,and the correlation between the above indicators and early diabetes nephropathy was analyzed.The ROC curve was drawn to analyze the diagnostic value of the above indicators for early diabetes nephropathy by single and combined detection.Results The levels of GA,HbA1c,cystatin and urinary pentaprotein in early diabetes nephropathy group were significantly higher than those in simple diabetes group(P<0.05);Pearson correlation analysis showed that GA,HbA1c,cystatin and urinary pentaprotein levels were positively correlated with early diabetes nephropathy(P<0.05);ROC analysis results showed that the area under the curve(AUC)of GA,HbA1c,cystatin and urinary pentaprotein levels in the diagnosis of early diabetes nephropathy was 0.860,0.790,0.745,0.932,0.868,0.747,0.858 and 0.885,respectively,while the AUC of combined detection was 0.994.Conclusion GA,HbA1c,cystatin and urinary pentaprotein have certain diagnostic value for early diabetes nephropathy,and the diagnostic accuracy of combined detection is higher than that of individual detection of each index.