早期糖尿病肾病患者血清NRG4、 Irisin水平及意义

Serum Nrg4 and Irisin Levels and Their Significance in Patients with Early DiabeticNephropathy

目的:探讨早期糖尿病肾病(early diabetic nephropathy,EDN)患者血清神经调节蛋白4(neuregulin4,NRG4)、鸢尾素(Irisin)水平及意义。方法:本研究纳入2022年1月-2022年12月178例糖尿病患者,诊断EDN发生情况,设为EDN组以及非EDN组,分别为26例,152例,并纳入同期入院体检的50名志愿者,设为对照组,比较三组患者血清NRG4、Irisin水平。以是否出现肾功能损伤为因变量,血清NRG4、Irisin水平为自变量进行二元Logistics回归分析,通过受试者工作曲线(receiveroperating characteristic,ROC)分析二者预测早期糖尿病肾病的价值。结果:EDN组血清NRG4、Irisin水平显著低于非EDN组以及对照组,非EDN组血清NRG4、Irisin水平显著低于对照组,(P<0.05);二元Logistics回归分析显示血清NRG4、Irisin水平是EDN的影响因素,二者联合诊断EDN曲线下面积(the are aunder the ROC curve,AUC)较单独诊断更高,敏感性0.91,特异性0.92;NRG4诊断EDN的AUC值、敏感性、特异性均高于Irisin。结论:EDN患者血清Nrg4、Irisin水平较糖尿病患者及正常人群下降,二者与EDN密切相关,联合诊断EDN具有一定的价值。

Objective:To investigate the levels and significance of serum neuregulin4(NRG4)and irisin in patients with early diabetic nephropathy(EDN).Methods:A total of 178 diabetic patients from January 2022 to December 2022 were included into this study,and set up as EDN group as well as non-EDN group(26 cases and 152 cases),respectively.Fifty volunteers who were admitted to the hospital for physical examination during the same period were included and set up as the control group.Serum NRG4 and Irisin levels were compared among the three groups.A binary Logistics regression analysis was performed with the presence of renal impairment as the dependent variable and serum NRG4 and Irisin levels as independent variables.The predictive value of both independent variables on EDN was analyzed by the receiver operating characteristic curve(ROC).Results:The serum NRG4 and Irisin levels in the EDN group were significantly lower than those in the non-EDN group and the control group,and the serum NRG4 and Irisin levels in the non-EDN group were significantly lower than those in the control group(P<0.05).The binary logistics regression analysis showed that low NRG4 and Irisin levels were the risk factors of EDN,and the area under the ROC curve(AUC)of the combined diagnosis for EDN was higher than that of single factor,with a sensitivity of 0.91 and specificity of 0.92.The AUC value,sensitivity,and specificity of NRG4 for the diagnosis of EDN were higher than those of Irisin.Conclusion:EDN serum Nrg4 and Irisin levels are decreased in EDN patients compared with diabetic patients and normal population,both of which are closely related to EDN.Combined test including both NRG4 and Irisin is valuable for diagnosing EDN.