血清CysC、补体C1q、KIM-1在糖尿病肾病中的表达及其早期诊断价值

Expression of Serum CysC,Complement C1q and KIM-1 in Diabetic Nephropathy and Their Value in Early Diagnosis

目的探讨血清胱抑素C(CysC)、补体C1q及肾脏损伤因子-1(KIM-1)在糖尿病肾病(DN)中的表达及早期诊断价值。方法选取我院2型糖尿病(T2DM)患者85例(2021年3月~2022年10月)作为研究对象,尿微量白蛋白排泄率(UAER)≥30 mg/24 h为DN组(n=44),UAER<30 mg/24 h为单纯T2DM组(n=41);另取本院同期健康体检者52例为健康组。分别检测3组血清CysC、补体C1q及尿KIM-1水平,Logistic回归分析血清CysC、补体C1q及尿KIM-1水平与DN的关系,并比较联合诊断、单独诊断价值。结果DN组、单纯T2DM组血清CysC、补体C1q及尿KIM-1水平较健康组高,且DN组血清CysC、补体C1q及尿KIM-1水平较单纯T2DM组高(P<0.05);经Logistic回归分析,结果表明,血清CysC、补体C1q及尿KIM-1水平升高均是DN发生的危险因素(P<.05);联合诊断灵敏度高于单独CysC、补体C1q及尿KIM-1诊断(P<0.05);CysC、补体C1q、尿KIM-1联合诊断的AUC值0.871大于单一指标诊断(P<0.05)。结论DN患者血清CysC、补体C1q及尿KIM-1表达异常升高,联合检测其水平具有较高灵敏度,可为临床早期筛查DN提供可靠依据。

Objective To investigate the expression of serum cystatin C(CysC),complement C1q and kidney damage factor-1(KIM-1)in diabetic nephropathy(DN)and its value in early diagnosis.Methods A total of 85 patients with type 2 diabetes mellitus(T2DM)in our hospital from March 2021 to October 2022 were selected as the study subjects.Urinary microalbumin excretion rate(UAER)≥30 mg/24 h was in the DN group(n=44),and UAER<30 mg/24 h was in the simple T2DM group(n=41).In addition,52 healthy persons in our hospital during the same period were selected as healthy group.The serum CysC,complement C1q and urine KIM-1 levels of the 3 groups were detected,and the relationship between serum CysC,complement C1q and urine KIM-1 levels and DN was analyzed by Logistic regression,and the value of combined diagnosis and single diagnosis was compared.Results The serum CysC,complement C1q and urine KIM-1 levels in DN group and T2DM group were higher than those in healthy group,and the serum CysC,complement C1q and urine KIM-1 levels in DN group were higher than those in T2DM group(P<0.05).Logistic regression analysis showed that increased levels of serum CysC,complement C1q and urine KIM-1 were risk factors for DN(P<0.05).The sensitivity of combined diagnosis was higher than that of CysC,complement C1q and urine KIM-1 alone(P<0.05).The AUC value of 0.871 in the combined diagnosis of CysC,complement C1q and urine KIM-1 was higher than that in the single diagnosis(P<0.05).Conclusion The expression of CysC,complement C1q and urine KIM-1 in patients with DN is abnormally elevated.The combined detection of these levels is highly sensitive and can provide reliable basis for early clinical screening of DN.