血清抗衰老因子、分泌型卷曲相关蛋白-1、C反应蛋白在糖尿病肾病患者检测中的临床价值

Clinical value of serum anti-aging factor, secreted frizzled related protein-1 and C-reactive protein in diabetic nephropathy patients

目的探讨血清抗衰老因子(Klotho)、分泌型卷曲相关蛋白-1(sfrp-1)、C反应蛋白(CRP)在糖尿病肾病(DN)患者检测中的临床价值。方法采用回顾性分析法,选取2020年11月至2022年11月九江市第一人民医院内分泌科收治的60例DN患者作为DN组,并纳入60例同期进行体检的健康者作为对照组,检测DN组和对照组血清中Klotho、sfrp-1以及CRP水平的变化,根据肾损伤情况,将DN组分为单纯糖尿病组[尿蛋白排泄率(UAER)<20μg/min]、早期DN组(200μg/min≥UAER≥20μg/min)和临床期DN组(UAER>200μg/min),比较各组患者血清Klotho、sfrp-1以及CRP水平。采用受试者工作特征(ROC)曲线分析血清Klotho、sfrp-1、CRP对肾损伤程度的诊断价值。结果DN组sfrp-1、CRP水平高于对照组,Klotho水平低于对照组,差异有统计学意义(P<0.05);临床期DN组Klotho水平低于早期DN组和单纯糖尿病组,且早期DN组Klotho水平低于单纯糖尿病组,临床期DN组sfrp-1、CRP水平高于早期DN组和单纯糖尿病组,且早期DN组sfrp-1、CRP水平高于单纯糖尿病组,差异有统计学意义(P<0.05);Spearman分析结果显示,DN患者Klotho水平与肾损伤程度呈负相关,Psfrp-1、CRP水平与肾损伤程度成正相关(P<0.05);Klotho、sfrp-1、CRP三者联合诊断肾损伤程度的ROC曲线下面积(AUC)面积高于单独检测。结论DN患者肾损伤程度越高,血清sfrp-1、CRP水平越高,血清Klotho水平越低。

Objective To investigate the clinical value of serum anti-aging factor(Klotho),secreted frizzled related protein-1(sfrp-1)and C-reactive protein(CRP)in the detection of diabetic nephropathy(DN)patients.Methods By retrospective analysis,60 patients with DN admitted to the First People's Hospital of Jiujiang from November 2020 to November 2022 were selected as the DN group,and 60 healthy subjects who underwent physical examination during the same period were included as the control group.The changes of serum Klotho,sfrp-1 and CRP levels in the DN group and the control group were detected.The DN group was divided into simple diabetes group(urinary protein excretion rate[UAER]<20μg/min],early DN group(200μg/min≥UAER≥20μg/min)and clinical DN group(UAER>200μg/min),and the serum levels of Klotho,sfrp-1 and CRP were compared among all groups.The diagnostic value of serum Klotho,sfrp-1 and CRP on the degree of renal injury was analyzed by receiver operating characteristics(ROC)curve.Results The levels of sfrp-1 and CRP in DN group were higher than those in control group,and the level of Klotho wes lower than that in control group,with statistical significance(P<0.05).The level of Klotho in clinical stage DN group was lower than that in early stage DN group and simple diabetes group,the level of Klotho in the early DN group was lower than that in the simple diabetes group,and the levels of sfrp-1 and CRP in clinical stage DN group were higher than those in early stage DN group and simple diabetes group,the levels of sfrp-1 and CRP in early stage DN group were higher than those in simple diabetes group,with statistical significance(P<0.05).Spearman analysis showed that Klotho level was negatively correlated with the degree of kidney injury in DN patients,while Psfrp-1 and CRP levels were positively correlated with the degree of kidney injury(P<0.05).The area under ROC curve(AUC)of Klotho,sfrp-1 and CRP combined in the diagnosis of kidney injury was higher than that of single detection.Conclusion The higher the degree of renal injury in DN patients,the higher the level of serum sfrp-1 and CRP,and the lower the level of serum Klotho.