a Department of Nephropathy , Xiangya Hospital Central-South University , Changsha , Hunan 410008 , China.
b Department of Cardiology , Xiangya Hospital Central-South University , Changsha , Hunan 410008 , China.
Ren Fail. 2018 Nov;40(1):547-553. doi: 10.1080/0886022X.2018.1487860.
This study aimed to assess whether neutrophil gelatinase-associated lipocalin (NGAL) and fibroblast growth factor 23 (FGF23) could be reliable biomarkers for early diagnosis of contrast-induced nephropathy (CIN).
202 patients who underwent percutaneous coronary intervention (PCI) were included in the research. All subjects were divided into CIN group and non-CIN group. Serum NGAL and FGF23 were evaluated before and 0, 1, and 2 days after PCI. Serum levels of these two markers were compared intra-group and among groups. Receiver-operating characteristic (ROC) analysis and logistic regression models were conducted to assess the diagnostic performance of NGAL and FGF23 in detecting CIN.
When compared with baseline values, serum levels of both NGAL and FGF23 in all subjects increased after PCI, and the values peaked 1 day after PCI, but the changing was greater in CIN group. There were obvious differences between two groups in serum NGAL after 1, 2 days, and similar differences present in serum FGF23 after 1 day. ROC analysis showed that the area under the curve (AUC) of relative values (percent change from the baseline) in NGAL after 1 day was 0.899 (95% CI: 0.834-0.964, p = .000), the optimum cutoff was 49% (sensitivity = 80%, specificity = 92.4%). And the AUC in FGF23 was 0.814 (95% CI: 0.733-0.894, p = .000), the optimum cutoff was 20% (sensitivity = 73.3%, specificity = 87.6%). Both serum NGAL and serum FGF23 could improve the clinical models in identifying CIN.
NGAL and FGF23 may have certain value in early diagnosis of CIN.
本研究旨在评估中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和成纤维细胞生长因子 23(FGF23)是否可作为对比剂诱导肾病(CIN)早期诊断的可靠生物标志物。
本研究纳入 202 例行经皮冠状动脉介入治疗(PCI)的患者。所有患者均分为 CIN 组和非 CIN 组。在 PCI 前及 PCI 后 0、1 和 2 天评估血清 NGAL 和 FGF23。比较组内和组间这两种标志物的血清水平。采用受试者工作特征(ROC)分析和逻辑回归模型评估 NGAL 和 FGF23 检测 CIN 的诊断性能。
与基线值相比,所有患者的血清 NGAL 和 FGF23 水平在 PCI 后均升高,且在 PCI 后 1 天达到峰值,但 CIN 组的变化更大。在 PCI 后 1、2 天,两组间血清 NGAL 差异明显,在 PCI 后 1 天,两组间血清 FGF23 差异亦明显。ROC 分析显示,PCI 后 1 天相对值(与基线相比的百分比变化)NGAL 的曲线下面积(AUC)为 0.899(95%CI:0.834-0.964,p=0.000),最佳截断值为 49%(灵敏度=80%,特异性=92.4%)。FGF23 的 AUC 为 0.814(95%CI:0.733-0.894,p=0.000),最佳截断值为 20%(灵敏度=73.3%,特异性=87.6%)。血清 NGAL 和 FGF23 均可改善识别 CIN 的临床模型。
NGAL 和 FGF23 可能在 CIN 的早期诊断中具有一定价值。