血清血管生成抑制蛋白-1成纤维生长因子-23联合尿β2-微球蛋白对DN的诊断价值

The diagnostic value of serum vasohibin-1 fibroblast growth factor-23 combined with urinary β2-microglobulin for diabetes nephropathy

目的探究血清血管生成抑制蛋白-1(VASH-1)、成纤维生长因子-23(FGF23)联合尿β2-微球蛋白(β2-MG)对糖尿病肾病(DN)的诊断价值。方法选取2022年1月至2023年5月在焦作煤业(集团)有限责任公司中央医院进行治疗的115例DN患者作为DN组,选取同时期本院60例健康体检者为对照组。根据24 h尿清蛋白排泄率(URER),将DN组分为单纯糖尿病组(A组,35例)、微量清蛋白尿组(B组,41例)和大量清蛋白尿组(C组,39例);比较受试者血清VASH-1、FGF-23水平、尿素、肌酐含量、尿β2-MG水平;采用Pearson法对血清VASH-1、FGF-23水平与尿素、肌酐含量、尿β2-MG水平进行相关性分析;采用多因素logistic回归分析DN发生的影响因素;受试者工作特征(ROC)曲线分析血清VASH-1、FGF-23联合尿β2-MG对DN的诊断价值。结果DN组血清VASH-1、FGF-23、尿素、肌酐含量、尿β2-MG水平均高于对照组(P<0.05);C组患者血清VASH-1、FGF-23、尿素、肌酐含量、尿β2-MG水平均高于B组和A组(P<0.05);DN患者血清VASH-1、FGF-23水平与尿素、肌酐含量、尿β2-MG水平均呈正相关(P<0.05);血清VASH-1、FGF-23、尿素、肌酐含量、尿β2-MG水平均为影响DN发生的危险因素(P<0.05);血清VASH-1、FGF-23、尿β2-M联合诊断DN价值高于单独诊断(Z_(三者联合-VASH-1)=4.389、P<0.001,Z_(三者联合-FGF-23)=3.117、P=0.002,Z_(三者联合-β2-MG)=4.556、P<0.001)。结论DN患者血清VASH-1、FGF-23、尿β2-MG水平与疾病的发生发展有关,且三者联合诊断效果较好,有望为DN的诊断提供一定的临床诊断价值。

Objective To explore the diagnostic value of serum vasohibin-1(VASH-1),fibroblast growth factor-23(FGF23)and urinary β2-microglobulin(β2-MG)in diabetes nephropathy(DN).Methods A total of 115 patients with DN who underwent treatment at the Central Hospital of Jiaozuo Coal Industry(Group)Co Ltd from January 2022 to May 2023 were selected as the DN group,and 60 healthy examinees from our hospital were regarded as the control group.The DN group was separated into normal albuminuria group(A group,35 cases),microalbuminuria group(B group,41 cases),and macroalbuminuria group(C group,39 cases)based on 24-hour urinary albumin excretion rate(URER).The levels of serum VASH-1 and FGF-23 levels,urea,creatinine levels,and urinary β2-MG levels were compared;Pearson method was applied to analyze the correlation between serum VASH-1,FGF-23 levels,urea,creatinine levels,and urinary β2-MG level;multivariate logistic regression was applied to analyze the influencing factors of DN occurrence;receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum VASH-1,FGF-23 combined with urine β2-MG for DN.Results The levels of serum VASH-1,FGF-23,urea,creatinine levels,and urine β2-MG in the DN group were obviously higher than those in the control group(P<0.05);the levels of serum VASH-1,FGF-23 levels,urea,creatinine levels,and urinary β2-MG in group C were obviously higher than those in group B and group A(P<0.05);the levels of serum VASH-1 and FGF-23 in DN patients were positively correlated with urea,creatinine,and urinary β2-MG(P<0.05);the levels of serum VASH-1,FGF-23 levels,urea,creatinine,and urine β2-MG were risk factors for DN(P<0.05);the combined diagnostic value of serum VASH-1,FGF-23,and urinary β2-M for DN was higher than that of individual diagnosis(Z_(three combination-VASH-1)=4.389,P<0.001,Z_(three combination-FGF-23)=3.117,P=0.002,Z_(three combination-β2-MG)=4.556,P<0.001).Conclusion The serum VASH-1,FGF-23,and urine β2-MG levels in DN patients are related to the occurrence and development of disease,and the combined diagnosis of the three is effective,which is expected to provide certain clinical diagnostic value for the diagnosis of DN.