血清NGAL、尿β2-MG、UACR对Ⅱ型糖尿病早期肾病的预测价值

Prognostic value of serum NGAL,urinaryβ2-MG and UACR in early nephropathy with type 2 diabetes mellitus

目的探究血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、β2-微球蛋白(β2-MG)、尿清蛋白与肌酐比值(UACR)对Ⅱ型糖尿病早期肾病的预测价值。方法分析解放军总医院第五医学中心和汉中市中心医院2021年8月至2023年7月收治的106例Ⅱ型糖尿病早期肾病患者为研究组,并选取同期体检的56例仅患有糖尿病患者为对照组。收集所有受试者的临床资料,比较两组患者的一般资料和血清NGAL、尿β2-MG、UACR水平;采用多因素logistic回归分析影响Ⅱ型糖尿病早期肾病发生的影响因素;采用Pearson相关性分析血清NGAL、尿β2-MG、UACR与患者肾功能的相关性,并采用受试者工作特征曲线(ROC)及曲线下面积(AUC)评估血清NGAL、尿β2-MG、UACR对Ⅱ型糖尿病早期肾病的预测价值。结果两组的eGFR、CysC、BUN、NGAL、β2-MG、UACR水平进行比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示eGFR、CysC、BUN、NGAL、β2-MG、UACR水平均是影响Ⅱ型糖尿病早期肾病发生的因素(P<0.05)。Pearson相关性分析结果显示,血清NGAL、尿β2-MG、UACR与eGFR呈负相关性(P<0.05)。ROC曲线显示,血清NGAL、尿β2-MG、UACR及三者联合预测Ⅱ型糖尿病早期肾病的AUC面积分别为0.879、0.887、0.890、0.990,这表明三者均具有较好的预测价值,且三者联合预测的效果最佳(P<0.05)。结论血清NGAL、尿β2-MG、UACR均是Ⅱ型糖尿病早期肾病发生的影响因素三者对于Ⅱ型糖尿病早期肾病的发生具有一定的预测价值,且三者联合预测的效果最好。

Objective To investigate the predictive value of serum neutrophil gelatinase-associated lipid carrier protein(NGAL),β2-microglobulin(β2-MG)and urinary albumin to creatinine ratio(UACR)in early nephropathy of type 2 diabetes mellitus.Methods A total of 106 patients with type 2 diabetic early nephropathy admitted to the Fifth Medical Center of the PLA General Hospital and Hanzhong Central Hospital from August 2021 to July 2023 were selected as the study group,and 56 patients with diabetes only were selected as the control group.Clinical data of all subjects were collected,and the general data and serum NGAL,urinaryβ2-MG and UACR levels were compared between the two groups.Multivariate logistic regression was used to analyze the influencing factors of early nephropathy in type 2 diabetes mellitus.Pearson correlation was used to analyze the correlation between serum NGAL,urinaryβ2-MG,UACR and renal function,and receiver operating characteristic curve(ROC)and area under the curve(AUC)were used to evaluate the predictive value of serum NGAL,urinaryβ2-MG,UACR in early nephropathy of type 2 diabetes.Results The levels of eGFR,CysC,BUN,NGAL,β2-MG,and UACR were compared between the two groups,and the differences were statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that eGFR,CysC,BUN,NGAL,β2-MG,and UACR levels were all factors affecting the occurrence of early nephropathy in type 2 diabetes mellitus(P<0.05).The results of Pearson correlation analysis showed that serum NGAL,urinaryβ2-MG,and UACR were negatively correlated with eGFR(P<0.05).The ROC curve showed that the AUC area of serum NGAL,urinaryβ2-MG,UACR,and their combination in predicting early nephropathy of typeⅡdiabetes was 0.879,0.887,0.890 and 0.990,respectively,indicating that the three had good predictive value,and the combined prediction effect of the three was the best(P<0.05).Conclusion Serum NGAL,urinaryβ2-MG and UACR are all influential factors for the occurrence of early nephropathy in type 2 diabetes mellitus.These three factors have certain predictive value for the occurrence of early nephropathy in type 2 diabetes mellitus,and their combined predictive effect is the strongest.