补体与炎症生物标志物与糖尿病肾病的关联
Association of Complement and Inflammatory Biomarkers with Diabetic Nephropathy.
作者信息
Huang Huiya, Li Dengren, Huang Xiaozhong, Wang Ying, Wang Shiyuan, Wang Ximei, Yang Xiangdong
机构信息
Department of Nephrology, Qilu Hospital of Shandong University, Jinan.
Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou.
出版信息
Ann Clin Lab Sci. 2019 Sep;49(4):488-495.
OBJECTIVE
To investigate the association between complement and inflammatory biomarkers with diabetic nephropathy (DN) in type 2 diabetes mellitus (T2DM).
METHODS
Plasma and urinary complement and inflammatory biomarkers were measured in 115 T2DM patients assigned to one of two groups: with DN (n=48) and without DN (n=67).
RESULTS
The plasma and urinary levels of C3a, C4d, C5a, sC5b-9 and MBL (mannan-binding lectin) were significantly higher in T2DM patients with DN compared to T2DM patients without DN. The plasma levels of IL-10 and INF-γ, as well as the urinary levels of INF-γ and TNF-α in T2DM patients with DN, were significantly higher than T2DM patients without DN. Both urinary MBL and INF-γ were independent risk factors for DN within T2DM patients (OR, 2.35 (95% CI 2.28-2.64) and 1.17 (95% CI 1.15-1.18); =0.000 and 0.016, respectively). The area under the receiver-operating-characteristic-curve for urinary MBL was 0.89, with sensitivity 91% and specificity 83% for DN. The area under the receiver-operating-characteristic-curve for INF-γ was 0.84, with sensitivity 86% and specificity 79% based on cutoff values of 1.42 ng/mg and 5.15 pg/mg, respectively.
CONCLUSION
This study suggests that urinary INF-γ and MBL levels are independent risk factors with a high predictive power for DN in T2DM patients.
目的
探讨2型糖尿病（T2DM）患者中补体和炎症生物标志物与糖尿病肾病（DN）之间的关联。
方法
对115例T2DM患者进行分组检测血浆和尿液中的补体及炎症生物标志物，分为两组：患有DN的患者（n = 48）和未患DN的患者（n = 67）。
结果
与未患DN的T2DM患者相比，患有DN的T2DM患者血浆和尿液中的C3a、C4d、C5a、sC5b - 9和MBL（甘露聚糖结合凝集素）水平显著更高。患有DN的T2DM患者的血浆IL - 10和INF - γ水平，以及尿液中的INF - γ和TNF - α水平，均显著高于未患DN的T2DM患者。尿液中的MBL和INF - γ均为T2DM患者发生DN的独立危险因素（OR分别为2.35（95%CI 2.28 - 2.64）和1.17（95%CI 1.15 - 1.18）；P值分别为0.000和0.016）。尿液MBL的受试者工作特征曲线下面积为0.89，对DN的敏感性为91%，特异性为83%。INF - γ的受试者工作特征曲线下面积为0.84，基于截断值分别为1.42 ng/mg和5.15 pg/mg时，对DN的敏感性为86%，特异性为79%。
结论
本研究表明，尿液INF - γ和MBL水平是T2DM患者发生DN的具有高预测能力的独立危险因素。
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