Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China.
Institute of Infectious Disease, Medical College of Xiamen University, Xiamen, China.
Nephrology (Carlton). 2020 May;25(5):398-405. doi: 10.1111/nep.13642. Epub 2019 Aug 29.
To explore whether serum pro-gastric releasing peptide (proGRP) is elevated in nephropathy patients and evaluate the diagnostic value of proGRP in chronic kidney disease (CKD) patients.
A total of 498 nephropathy patients and 170 healthy were selected in Zhongshan Hospital, Medical College of Xiamen University, from February 2016 to September 2017. The clinical data of the different groups including serum proGRP, CKD grading, and other serum and urine renal function biomarkers were analyzed by group comparison, correlation analysis and receiver operating characteristic curve.
Serum proGRP levels were significantly higher in the acute kidney injury and CKD groups compared with the other groups of kidney disease patients (P < 0.01), and increased with CKD grading (P < 0.01). Serum proGRP was substantially correlated with serum creatinine (r = 0.637, P < 0.01) and cystain C (0.837, P < 0.01). Serum proGRP had moderate correlations with urine β2-macroglobulin (β2-m; r = 0.587, P < 0.01) and α1-macroglobulin (α1-m; r = 0.557, P < 0.01). There were fair associations of serum proGRP with albumin (r = 0.10, P = 0.067), 24 h proteinuria (24 h-TPU; r = 0.092, P = 0.099), urinary albumin/urocreatinine (uAlb/Cr; r = 0.29, P < 0.01) and urinary N-acetyl-β-D-glucosidase (r = -0.142, P < 0.01). The sensitivity of proGRP was superior to that of simplified modification of diet in renal disease (MDRD) formula in diagnosing CKD I + II (81.25% vs 66.67%), CKD III (86.42% vs 74.36%) and CKD IV (71.19% vs 69.64%), while its specificity was inferior to that of simplified MDRD formula in diagnosing CKD I + II (37.65% vs 66.97%), CKD III (56.25% vs 86.67%) and CKD IV (75.31% vs 88.46%).
Serum proGRP is elevated in acute renal injury and CKD patients and increases with CKD grading. Serum proGRP is mainly affected by glomerular filtration rate and could be used for CKD staging, although the overall diagnostic sufficiency is inferior to simplified MDRD formula.
探讨肾病患者血清胃泌素释放肽前体（proGRP）是否升高，并评估 proGRP 在慢性肾脏病（CKD）患者中的诊断价值。
选取 2016 年 2 月至 2017 年 9 月厦门大学医学院附属中山医院收治的肾病患者 498 例和健康人 170 例，对不同组的临床资料（包括血清 proGRP、CKD 分级及其他血清和尿液肾功能生物标志物）进行组间比较、相关性分析和受试者工作特征曲线分析。
与其他肾病患者组相比，急性肾损伤和 CKD 组的血清 proGRP 水平显著升高（P<0.01），且随 CKD 分级增加而升高（P<0.01）。血清 proGRP 与血肌酐（r=0.637，P<0.01）和胱抑素 C（0.837，P<0.01）呈显著正相关。血清 proGRP 与尿β2-微球蛋白（β2-m；r=0.587，P<0.01）和α1-巨球蛋白（α1-m；r=0.557，P<0.01）有中度相关性。血清 proGRP 与白蛋白（r=0.10，P=0.067）、24 小时尿蛋白（24 h-TPU；r=0.092，P=0.099）、尿白蛋白/尿肌酐（uAlb/Cr；r=0.29，P<0.01）和尿 N-乙酰-β-D-氨基葡萄糖苷酶（r=-0.142，P<0.01）呈轻度相关。proGRP 对 CKD I+II（81.25%比 66.67%）、CKD III（86.42%比 74.36%）和 CKD IV（71.19%比 69.64%）的诊断敏感性优于简化肾脏病膳食改良公式（MDRD），但其特异性则低于简化 MDRD（37.65%比 66.97%、56.25%比 86.67%和 75.31%比 88.46%）。
血清 proGRP 在急性肾损伤和 CKD 患者中升高，并随 CKD 分级增加而升高。血清 proGRP 主要受肾小球滤过率影响，可用于 CKD 分期，但总体诊断效能逊于简化 MDRD 公式。
