2型糖尿病患者尿液中血管细胞黏附分子-1水平与肾脏损伤的相关性研究
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摘要
目的探讨2型糖尿病患者尿液中血管细胞黏附分子-1(VCAM-1)水平与肾脏损伤的相关性及其临床意义。方法选取117例2型糖尿病患者和25例健康体检者(正常对照组),检测尿VCAM-1、尿微量白蛋白、血清肌酐的水平,计算糖尿病患者的肾小球滤过率(e GFR)。分析尿液VCAM-1与尿微量白蛋白、e GFR的相关性,ROC曲线评价VCAM-1在评估2型糖尿病患者肾脏损伤中的临床意义。结果糖尿病患者的VCAM-1水平高于正常对照组,差异有统计学意义(P<0.01);VCAM-1水平与e GFR呈负相关(r=-0.809,P<0.01);VCAM-1与尿微量白蛋白及血清肌酐均呈正相关(r值分别为0.812、0.758,P<0.01);VCAM-1诊断糖尿病肾病的AUC为0.951,临界值为38.26 ng/ml。结论检测糖尿病患者尿液VCAM-1水平对疾病诊断及病情判断具有一定的参考价值。
Objective To investigate the relationship between the levels of vascular cell adhesion molecule-1( VCAM-1) and renal injury in patients with type 2 diabetes mellitus and its clinical significance.Methods Urinary VCAM-1,urinary albumin,serum creatinine levels of 117 patients with type 2 diabetes and 25 cases of healthy persons( control group) were detected.The glomerular filtration rate( e GFR) in diabetic patients was calculated,and its correlation between urinary VCAM-1 and urinary albumin and e GFR was performed.ROC curve was used to evaluate the clinical significance of VCAM-1 in patients with type 2 diabetes mellitus.Results The levels of VCAM-1 in patients with diabetes were significantly higher than control group,with the difference statistically significant( P < 0.01).VCAM-1 levels and e GFR showed a significant negative correlation( r =-0.809,P < 0.01).VCAM-1 had a positive correlation with urinary albumin and serum creatinine( r = 0.812,0.758,P < 0.01).AUC of VCAM-1 was 0.951 in the diagnosis of diabetic nephropathy,and the critical value was38.26 ng/ml.Conclusion Detection of urine VCAM-1 level has certain reference value to the diagnosis and the condition of diabetic nephropathy.
Objective To investigate the relationship between the levels of vascular cell adhesion molecule-1( VCAM-1) and renal injury in patients with type 2 diabetes mellitus and its clinical significance.Methods Urinary VCAM-1,urinary albumin,serum creatinine levels of 117 patients with type 2 diabetes and 25 cases of healthy persons( control group) were detected.The glomerular filtration rate( e GFR) in diabetic patients was calculated,and its correlation between urinary VCAM-1 and urinary albumin and e GFR was performed.ROC curve was used to evaluate the clinical significance of VCAM-1 in patients with type 2 diabetes mellitus.Results The levels of VCAM-1 in patients with diabetes were significantly higher than control group,with the difference statistically significant( P < 0.01).VCAM-1 levels and e GFR showed a significant negative correlation( r =-0.809,P < 0.01).VCAM-1 had a positive correlation with urinary albumin and serum creatinine( r = 0.812,0.758,P < 0.01).AUC of VCAM-1 was 0.951 in the diagnosis of diabetic nephropathy,and the critical value was38.26 ng/ml.Conclusion Detection of urine VCAM-1 level has certain reference value to the diagnosis and the condition of diabetic nephropathy.
引文
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[13]林海仁,邢妃中.改良简化MDRD方程计算肾小球滤过率的影响因素研究[J].新医学,2014,45(7):464-467.
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[15]周芬,杨玉婷,华彦珺,等.CD4+T细胞对肺结核诊断的ROC曲线分析[J].中国卫生检验杂志,2015,25(19):3280-3282.
[16]刘琴,魏建波.ROC曲线评价MMP-2和MMP-9在类风湿关节炎诊断中的价值[J].中国卫生检验杂志,2014,24(4):531-533.
[2]Day DE,Oedorf K,Kogan S,et al.The utility of inflammatory and endothelial markers to identify infection in emergency department patients[J].Shock,2015,44(3):215-220.
[3]Cung H,Aragon MJ,Zychowski K,et al.Characterization of a novel endothelial biosensor assay reveals increased cumulative serum inflammatory potential in stabilized coronary artery disease patients[J].J Transl Med,2015,13:99.
[4]Tang LQ,Ni WJ,Cai M,et al.The renoprotective effects of berberine and its potential impact on the expression ofβ-arrestins and ICAM-1/VCAM-1 in streptozocin induced-diabetic nephropathy rats[J].J Diabetes,2016,8(5):693-700.
[5]Wu C,Yang M,Zhou Z,et al.Urinary soluble intercellular adhesion molecule-1 and vascular cellular adhesion molecule-1:potential biomarkers of active lupus nephritis[J].Nan Fang Yi Ke Da Xue Xue Bao,2015,35(9):1272-1276,1282.
[6]Liu JJ,Yeoh LY,Sum CF,et al.Vascular cell adhesion molecule-1,but not intercellular adhesion molecule-1,is associated with diabetic kidney disease in Asians with type 2 diabetes[J].J Diabetes Complications,2015,29(5):707-712.
[7]Sawires HK,Mohamed WA,Schaalan MF.High-flux and lowflux dialysis membranes and levels of intercellular adhesion molecule-1 andvascular cell adhesion molecule-1 in children with chronic kidney failure[J].Iran J Kidney Dis,2012,6(5):366-372.
[8]Zhu L,Shi S,Liu L,et al.Increased plasma s VCAM-1 is associated with severity in Ig A nephropathy[J].BMC Nephrol,2013,14(1):21.
[9]Reinhold SW,Straub RH,Krüger B,et al.Elevated urinary s VCAM-1,IL6,s IL6R and TNFR1 concentrations indicate acute kidney transplantrejection in the first 2 weeks after transplantation[J].Cytokine,2012,57(3):379-388.
[10]卢立肖,陈晓英,林瑞霞,等.儿童紫癜性肾炎血清、尿液VCAM-1水平及临床意义[J].中国中西医结合肾病杂志,2009,10(1):39-41.
[11]Howe HS,Kong KO,Thong BY,et al.Urine s VCAM-1 and s ICAM-1 levels are elevated in lupus nephritis[J].Int J Rheum Dis,2012,15(1):13-16.
[12]袁红波,楼季庄.MDRD与CKD-EPI方程在我国早期慢性肾脏病患者中应用的比较[J].现代医学,2013,41(4):245-247.
[13]林海仁,邢妃中.改良简化MDRD方程计算肾小球滤过率的影响因素研究[J].新医学,2014,45(7):464-467.
[14]张克坚,杨振华.应用ROC曲线图评价检验项目的临床准确性[J].临床检验信息,1999,4(3):105-108.
[15]周芬,杨玉婷,华彦珺,等.CD4+T细胞对肺结核诊断的ROC曲线分析[J].中国卫生检验杂志,2015,25(19):3280-3282.
[16]刘琴,魏建波.ROC曲线评价MMP-2和MMP-9在类风湿关节炎诊断中的价值[J].中国卫生检验杂志,2014,24(4):531-533.