人附睾蛋白4在糖尿病肾病中的诊断价值
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摘要
目的:探讨人附睾蛋白4(HE4)在糖尿病肾病(DN)中的诊断价值。方法:选取156例糖尿病患者和59名健康体检者进行对照研究,检测血清中HE4、胱抑素C(Cys C)、肌酐(SCr)浓度和尿微量白蛋白(MA);比较健康对照组、非糖尿病肾病组及糖尿病肾病组各组间血清HE4、CysC、Scr的差异;分析HE4与CysC、Scr、MA及eGFR的相关性,并使用ROC曲线分析HE4在糖尿病肾病的诊断价值。结果:糖尿病肾病组HE4、CysC和Scr结果明显高于非糖尿病肾病组和健康对照组(P<0.05);非糖尿病肾病组HE4结果高于健康对照组(P<0.05),而CysC和Scr结果与健康对照组相比没有差异(P>0.05);ROC曲线分析显示,血清HE4曲线下面积为0.962(95%CI 0.929-0.997),当血清HE4结果为69.7 pmol/L时,其诊断糖尿病肾病的敏感度及特异度分别为98.1%和97.9%;相关性分析显示HE4与CysC、Scr、MA呈正相关,与eGFR呈负相关(P<0.05)。结论:血HE4检测对糖尿病肾病具有一定的预测价值。
[Objective] To explore diagnostic value of human epididymis protein 4(HE4) in diabetic nephropathy(DN). [Method] 156 diabetic patients and 59 healthy people in control group were chosen to examine serum HE4, cystatin C(CysC), concentration of creatinine(SCr) and urine microalbumin. Difference of serum HE4, CysC and Scr in healthy control group, non-diabetic nephropathy group and diabetic nephropathy group was compared. Correction between HE4 and Cys C, Scr, MA and eGFR was analyzed. Meanwhile, ROC curve was taken to explore diagnostic value of HE4 in diabetic nephropathy. [Result] HE4, CysC and Scr in diabetic nephropathy group were obviously higher than that in diabetic non-nephropathy group and healthy control group(P<0.05). HE4 in diabetic non-nephropathy group was higher than that in healthy control group(P<0.05). There was no remarkable difference regarding CysC and Scr and healthy control group(P>0.05).ROC curve analysis showed When the serum HE4 level was 69.7 pmol/L the sensitivity and specificity of serum HE4 for the diagnosis of diabetic nephropathy was 98.1% and 97.9%,respectively,with an AUC of 0.962(95%CI 0.929-0.997). Correction analysis indicated that HE4 was of positive correlation to CysC, Scr and MA, and negative correlation to eGFR(P<0.05). [Conclusion] HE4 has certain predictive value for diabetic nephropathy.
[Objective] To explore diagnostic value of human epididymis protein 4(HE4) in diabetic nephropathy(DN). [Method] 156 diabetic patients and 59 healthy people in control group were chosen to examine serum HE4, cystatin C(CysC), concentration of creatinine(SCr) and urine microalbumin. Difference of serum HE4, CysC and Scr in healthy control group, non-diabetic nephropathy group and diabetic nephropathy group was compared. Correction between HE4 and Cys C, Scr, MA and eGFR was analyzed. Meanwhile, ROC curve was taken to explore diagnostic value of HE4 in diabetic nephropathy. [Result] HE4, CysC and Scr in diabetic nephropathy group were obviously higher than that in diabetic non-nephropathy group and healthy control group(P<0.05). HE4 in diabetic non-nephropathy group was higher than that in healthy control group(P<0.05). There was no remarkable difference regarding CysC and Scr and healthy control group(P>0.05).ROC curve analysis showed When the serum HE4 level was 69.7 pmol/L the sensitivity and specificity of serum HE4 for the diagnosis of diabetic nephropathy was 98.1% and 97.9%,respectively,with an AUC of 0.962(95%CI 0.929-0.997). Correction analysis indicated that HE4 was of positive correlation to CysC, Scr and MA, and negative correlation to eGFR(P<0.05). [Conclusion] HE4 has certain predictive value for diabetic nephropathy.
引文
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[5]中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识(2014年版)[J].中华糖尿病杂志,2014.11(6):792-801
[6]Chan P,Yang Q,Li X,et al.Potential association between elevated serum epididymis protein 4 and renal fibrosis:A systemic review and meta-analysis [J].Medicine(Baltimore),2017,96(36):e7824
[2]KDOQI Clinical Practice Guidelines for Diabetes and CKD:2012 update[J].Am J Kidney Dis,2012,60(5):850—86.
[3]American diabetes Association.Introduction:Standards of Medical Care in Diabetes -2018[J].Diabetes care ,2018,41(suppl l):S1-S2
[4]杨晓霞,柏明,刘丽敏,等.慢性肾脏病患者血清人附睾蛋白4与疾病进展的关系[J].肾脏病与透析肾移植杂志,2016,25(2):128-133.
[5]中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识(2014年版)[J].中华糖尿病杂志,2014.11(6):792-801
[6]Chan P,Yang Q,Li X,et al.Potential association between elevated serum epididymis protein 4 and renal fibrosis:A systemic review and meta-analysis [J].Medicine(Baltimore),2017,96(36):e7824