2型糖尿病患者血清抵抗素、VEGF、糖化白蛋白联合检测在糖尿病肾病早期诊断中的价值分析

The evaluation of combined detection of serum resistin,VEGF and glycated albumin in early diagnosis of diabetic nephropathy in patients with type 2 diabetes

目的探讨血清抵抗素、血管内皮细胞因子(VEGF)、糖化白蛋白(GA)联合诊断早期糖尿病肾病(DN)的应用价值。方法选取2014年1月至2017年1月就诊的T2DM患者152例作为研究对象,参照尿蛋白/尿肌酐比值(UACR)分为正常白蛋白尿组(NA组)68例、微量白蛋白尿组(MA组)45例、大量白蛋白尿组(LA组)39例,比较3组患者血清抵抗素、VEGF、GA变化及与UACR的关系,ROC曲线分析抵抗素、VEGF、GA及三者联合诊断早期DN的效能。结果 NA组抵抗素、VEGF、GA及UACR值低于MA组、LA组,MA组上述指标低于LA组,三者比较差异均有统计学意义(F=12.907、24.082、10.905、136.311,P<0.05);血清抵抗素、VEGF、GA与UACR均呈正相关分析(r=0.646、0.678、0.583,P<0.01);ROC分析显示血清抵抗素、VEGF、GA诊断早期DN的最佳节点值分别为50.53 ng/mL、95.12 pg/mL、20.08%,三者联合曲线下面积为0.874高于血清抵抗素(0.775)、VEGF(0.788)、GA(0.733)单独检测(Z=2.189、3.031、2.441,P=0.029、0.002、0.015)。结论血清抵抗素、VEGF、GA与UACR呈正相关关系,三者联合检测可提高早期诊断效能。

Objective To investigate the value of serum resistin,vascular endothelial cell factor(VEGF)and glycated albumin(GA)in the diagnosis of early diabetic nephropathy(DN). Methods A total of 152 patients with T2 DM who were admitted from January 2014 to January 2017 were enrolled. According to urinary albumin creatinine ratio(UACR),there were 68 cases of normal protein proteinuria group(NA group),45 cases of microalbuminuria group(MA group)and 39 cases of large albuminuria group(LA group).The changes of serum resistin,VEGF and GA and their relationships with UACR in the patients were compared among the 3 groups. ROC curve was performed to analyze the diagnostic efficiency of resistin,VEGF,GA and the combination of the three in the early diagnosis of DN. Results The resistin,VEGF,GA and UACR value in NA group were lower than those in MA group and LA group and the MA group was lower than the LA group(F=12.907,24.082,10.905,136.311,P<0.05). Serum resistin,VEGF and GA were positively correlated with UACR(r=0.646,0.678,0.583,P<0.01). ROC analysis showed that the best node values of serum resistin,VEGF and GA for early diagnosis of DN were 50.53 ng/mL,95.12 pg/mL and 20.08%. The area under curve of the three was 0.874,higher than that of serum resistin(0.775),VEGF(0.788)and GA(0.733)alone(Z=2.189,3.031,2.441,P=0.029,0.002,0.015). Conclusion Serum resistin,VEGF and GA are positively correlated with UACR. The combined detection of three can improve early diagnostic.