Hcy、NGAL和hs-CRP在糖尿病早期肾损伤诊断中的应用价值

The value of serum Hcy,NGAL and hs-CRP in the diagnosis of early renal injury in diabetes mellitus

目的探讨2型糖尿病(T2DM)患者血清同型半胱氨酸(Hcy)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和超敏C反应蛋白(hsCRP)在T2DM早期肾损伤诊断中的临床应用价值。方法选取T2DM患者124例,根据Mogensen分期法分成为正常蛋白尿期(单纯DM组,66例)和早期糖尿病肾病期(早期DN组,58例)两组,并选取60例健康体检者为对照组。检测并分析3组血清Hcy、NGAL、hs-CRP、肌酐(SCr)和尿微量白蛋白(m Alb)差异。结果早期DN组Hcy、NGAL、hs-CRP、SCr和m Alb水平高于单纯DM组和对照组,单纯DM组各指标均水平高于对照组,差异均无统计学意义(P>0.05)。Hcy、NGAL和hs-CRP水平与SCr检测水平呈正相关(r=0.795,0.841,0.875,P<0.05),与mAlb检测水平呈正相关(r=0.681,0.748,0.711,P <0.05)。结论血清Hcy、NGAL和hs-CRP可作为早期发现T2DM患者肾功能损伤的敏感指标,动态检测上述指标水平可为T2DM早期肾功能诊断提供参考依据。联合检测可提高T2DM早期肾损伤的检出率,有助于临床对T2DM早期肾损伤和预后判断。

Objective To investigate serum homocysteine(Hcy),neutrophil gelatinase-associated lipocalin(NGAL)and hypersensitive C-reactive protein(hs-CRP)in type 2 diabetes mellitus(T2DM)patients in early kidney of T2DM Clinical application value in injury diagnosis.Methods A total of 124 patients with T2DM were enrolled.According to the Mogensen staging method,they were divided into normal proteinuria(only DM group,66 cases)and early diabetic nephropathy(early DN group,58 cases).60 healthy subjects were selected as controls.group.Three groups of serum Hcy,NGAL,hs-CRP,creatinine(SCr)and urinary microalbumin(mAlb)were detected and analyzed.Results The levels of Hcy,NGAL,hs-CRP,SCr and mAlb in the early DN group were higher than those in the DM group and the control group.The levels of the indexes in the DM group were higher than those in the control group(P>0.05).The levels of Hcy,NGAL and hs-CRP were positively correlated with the level of SCr(r=0.795,0.841,0.875,P<0.05),and positively correlated with the level of mAlb(r=0.681,0.748,0.711,P<0.05).Conclusion Serum Hcy,NGAL and hs-CRP can be used as sensitive indicators for early detection of renal dysfunction in patients with T2DM.Dynamic detection of these markers can provide a reference for early renal function diagnosis of T2DM.Combined detection can improve the detection rate of early renal injury in T2DM,and help to judge the early renal injury and prognosis of T2DM.