NGAL、L-FABP 和蛋白尿在预测 2 型糖尿病患者 GFR 下降中的临床价值。
Clinical value of NGAL, L-FABP and albuminuria in predicting GFR decline in type 2 diabetes mellitus patients.
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.
出版信息
PLoS One. 2013;8(1):e54863. doi: 10.1371/journal.pone.0054863. Epub 2013 Jan 22.
OBJECTIVES
Neutrophil gelatinase-associated lipocalin (NGAL) and liver-type fatty acid binding protein (L-FABP) are emerging as excellent biomarkers in the urine and plasma for the early prediction of acute and chronic kidney injury. The aims of this prospective study were to determine the role of albuminuria, and that of serum and urine levels of NGAL and L-FABP as predictors of a decline in the glomerular filtration rate (GFR) in patients with type 2 diabetes.
METHODS
A longitudinal cohort study with one hundred forty type 2 diabetic patients was conducted. Serum and urine levels of NGAL and L-FABP, and the urine albumin excretion rate were determined. The correlation between the kidney injury biomarkers and rate of GFR decline was analyzed.
RESULTS
The eGFR of study subjects decreased significantly as the study progressed (86.4±31.1 vs. 74.4±27.3 ml/min/1.73 m(2), P<0.001), and the urine albumin excretion rate increased significantly (264.9±1060.3 vs. 557.7±2092.5 mg/day, P = 0.009). The baseline urine albumin excretion rate and serum L-FABP level were significantly correlated with baseline eGFR (P<0.05). The results of regression analysis for the correlations between the rate of eGFR change and the baseline levels of NGAL and L-FABP, and the urine albumin excretion rate showed that only the urine albumin excretion rate was significantly correlated with the rate of eGFR change (standardized coefficients: -0.378; t: -4.298; P<0.001).
CONCLUSIONS
Tubular markers, such as NGAL and L-FABP, may not be predictive factors associated with GFR decline in type 2 diabetic patients.
目的
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和肝型脂肪酸结合蛋白（L-FABP）作为尿液和血浆中急性和慢性肾损伤早期预测的优异生物标志物而出现。本前瞻性研究的目的是确定蛋白尿以及血清和尿液 NGAL 和 L-FABP 水平作为 2 型糖尿病患者肾小球滤过率（GFR）下降的预测因子的作用。
方法
进行了一项具有 140 例 2 型糖尿病患者的纵向队列研究。确定了血清和尿液 NGAL 和 L-FABP 的水平以及尿白蛋白排泄率。分析了肾脏损伤生物标志物与 GFR 下降率之间的相关性。
结果
随着研究的进行，研究对象的 eGFR 显著下降（86.4±31.1 与 74.4±27.3 ml/min/1.73 m2，P<0.001），并且尿白蛋白排泄率显著增加（264.9±1060.3 与 557.7±2092.5 mg/天，P=0.009）。基线尿白蛋白排泄率和血清 L-FABP 水平与基线 eGFR 显著相关（P<0.05）。对 NGAL 和 L-FABP 以及尿白蛋白排泄率的基线水平与 eGFR 变化率之间的相关性的回归分析结果表明，只有尿白蛋白排泄率与 eGFR 变化率显著相关（标准化系数：-0.378；t：-4.298；P<0.001）。
结论
肾小管标志物，如 NGAL 和 L-FABP，可能不是 2 型糖尿病患者与 GFR 下降相关的预测因子。
Zotero 插件