随机尿白蛋白肌酐比值对2型糖尿病患者微量及大量白蛋白尿检测的诊断效能
Diagnostic efficacy of random albumin creatinine ratio for detection of micro and macro-albuminuria in type 2 diabetes mellitus.
作者信息
Hasanato Rana M
机构信息
Department of Pathology, College of Medicine and University Hospitals, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
出版信息
Saudi Med J. 2016 Mar;37(3):268-73. doi: 10.15537/smj.2016.3.13567.
OBJECTIVES
To compare a less cumbersome random albumin creatinine ratio (RACR) with 24-hour urinary albumin excretion (UAE) for detection of renal damage in patients with type 2 diabetes mellitus (T2DM).
METHODS
This retrospective study performed between March 2013 and June 2014 at the Department of Pathology, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia included 122 patients (mean age 54 ± 15, 104 females and 18 males) with T2DM. Urine albumin levels of less than 30 mg/g was considered normal, from 30-300 mg/g considered as micro-albuminuria, and over 300 mg/g considered as macro-albuminuria.
RESULTS
Concordance between the 2 assays was observed in 114 (93.4%) samples. The sensitivity of RACR assay was 100%, specificity was 91.3% with a positive predictive value (PPV) of 95%, and a negative predictive value (NPV) of 100% in micro-albuminuria range. For macro-albuminuria, RACR had a sensitivity of 100%, specificity of 94.1% with PPV of 94% and NPV of 100%. Receiver operating characteristic (ROC) curves analysis cut-off values of 40 mg/g-300 mg/g for micro- and greater than 300 mg/g for macro-albuminuria revealed 100% sensitivity, 97.5% specificity, 95% PPV, and 100% NPV for micro-albuminuria, and 100% sensitivity, 94% specificity, 76% PPV, and 100% NPP for macro-albuminuria. The area under the curve for micro-albuminuria was 100% and 98.2% for macro-albuminuria.
CONCLUSION
Performance of RACR was comparable to 24 hour UAE assay particularly in excluding renal damage in T2DM.
目的
比较一种操作不太繁琐的随机白蛋白肌酐比值（RACR）与24小时尿白蛋白排泄率（UAE）在检测2型糖尿病（T2DM）患者肾损伤方面的效果。
方法
这项回顾性研究于2013年3月至2014年6月在沙特阿拉伯利雅得国王哈立德大学医院病理科进行，纳入了122例T2DM患者（平均年龄54±15岁，女性104例，男性18例）。尿白蛋白水平低于30mg/g被视为正常，30 - 300mg/g被视为微量白蛋白尿，超过300mg/g被视为大量白蛋白尿。
结果
在114份（93.4%）样本中观察到两种检测方法结果一致。在微量白蛋白尿范围内，RACR检测的灵敏度为100%，特异性为91.3%，阳性预测值（PPV）为95%，阴性预测值（NPV）为100%。对于大量白蛋白尿，RACR的灵敏度为100%，特异性为94.1%，PPV为94%，NPV为100%。受试者工作特征（ROC）曲线分析显示，微量白蛋白尿的截断值为40mg/g - 300mg/g，大量白蛋白尿的截断值大于300mg/g，微量白蛋白尿的灵敏度为100%，特异性为97.5%，PPV为95%，NPV为100%；大量白蛋白尿的灵敏度为100%，特异性为94%，PPV为76%，NPP为100%。微量白蛋白尿的曲线下面积为100%，大量白蛋白尿的曲线下面积为98.2%。
结论
RACR的性能与24小时UAE检测相当，尤其在排除T2DM患者的肾损伤方面。
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