早期糖尿病肾病患者血清鸢尾素、高迁移率族蛋白Box1、神经调节蛋白4水平变化及临床意义

Changes in Serum Irisin,High Mobility Group Box 1,and Neuregulin 4 Levels in Patients with Early Diabetic Kidney Disease and Their Clinical Significance

目的探讨早期糖尿病肾病(DKD)患者血清鸢尾素、高迁移率族蛋白B1(HMGB1)、神经调节蛋白4(NRG4)水平变化及临床意义。方法选取2022年3月至2024年3月郑州大学第一附属医院收治的80例早期DKD患者作为早期DKD组,选取同期50例健康体检人员作为健康对照组,对两组人口学特征、临床资料进行收集,对血清鸢尾素、HMGB1、NRG4水平进行检测,进行单因素与多因素Logistic回归分析,明确早期DKD发生的危险因素。结果两组患者年龄、性别、饮酒史、冠心病史、吸烟史、高血压史、舒张压、收缩压、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较差异无统计学意义(P>0.05);早期DKD组的血清鸢尾素、NRG4水平更低,HMGB1水平更高,差异均有统计学意义(P<0.05);多因素二元Logistic回归分析结果显示,血清鸢尾素(OR=0.568;95%CI:0.389~0.829)、NRG4(OR=0.456;95%CI:0.246~0.845)是影响早期DKD发生的保护性因素,差异具有统计学意义(P<0.05),HMGB1(OR=2.976;95%CI:2.664~3.325)是独立危险因素,差异具有统计学意义(P<0.05)。结论早期DKD患者血清鸢尾素、NRG4水平更低,HMGB1水平更高,临床可用血清鸢尾素、HMGB1、NRG4水平对早期DKD发生进行评估。

Objective To investigate the changes in serum irisin,high mobility group box 1(HMGB1),and neuregulin 4(NRG4)levels in patients with early diabetic kidney disease(DKD)and their clinical significance.Methods A total of 80 patients with early DKD treated at the first affiliated hospital of zhengzhou university from March 2022 to March 2024 were selected as the early DKD group,and 50 healthy individuals undergoing physical examination during the same period were selected as the healthy control group.Demographic characteristics and clinical data of the two groups were collected,and serum irisin,HMGB1,and NRG4 levels were measured.Univariate and multivariate logistic regression analyses were performed to identify risk factors for early DKD.Results There were no statistically significant differences in age,gender,history of alcohol consumption,history of coronary heart disease,history of smoking,history of hypertension,diastolic blood pressure,systolic blood pressure,high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)levels between the two groups(P>0.05).The early DKD group had lower serum irisin and NRG4 levels and higher HMGB1 levels,with statistically significant differences(P<0.05).Multivariate binary logistic regression analysis showed that serum irisin(OR=0.568;95%CI:0.389~0.829)and NRG4(OR=0.456;95%CI:0.246~0.845)were protective factors for early DKD,with statistically significant differences(P<0.05),while HMGB1(OR=2.976;95%CI:2.664~3.325)was an independent risk factor,with a statistically significant difference(P<0.05).Conclusion Patients with early DKD have lower serum irisin and NRG4 levels and higher HMGB1 levels.Serum irisin,HMGB1,and NRG4 levels can be used to assess the occurrence of early DKD.