中性粒细胞明胶酶相关脂质运载蛋白 (NGAL) 作为高血压患者早期肾功能衰竭检测的生物标志物的诊断价值：加纳一家地区医院的病例对照研究。

Diagnostic value of neutrophil gelatinase-associated lipocalin (NGAL) as an early biomarker for detection of renal failure in hypertensives: a case-control study in a regional hospital in Ghana.

机构信息

Department of Medical Laboratory Technology, Faculty of Applied Science and Technology, Sunyani Technical University, Sunyani, Ghana.

Department of Pharmaceutical Sciences, Faculty of Applied Science and Technology, Sunyani Technical University, Sunyani, Ghana.

出版信息

BMC Nephrol. 2023 Apr 26;24(1):114. doi: 10.1186/s12882-023-03120-6.

DOI:10.1186/s12882-023-03120-6

PMID:37101162

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10134524/

Abstract

BACKGROUND

Renal failure is one of the most serious vascular effects of hypertension. For better therapy and prevention of complications, early kidney disease identification in these patients is absolutely essential. However, current studies have proposed plasma Neutrophil Gelatinase Associated Lipocalin (pNGAL) to be a better biomarker comparative to serum creatinine (SCr). This study assessed the diagnostic utility of plasma neutrophil gelatinase-associated lipocalin (pNGAL) as a biomarker for early nephropathy diagnosis in hypertensive individuals.

METHODS

This hospital-based case-control study comprised 140 hypertensives and 70 healthy participants. A well-structured questionnaire and patient case notes were used to document relevant demographic and clinical information. 5 ml of venous blood sample was taken to measure fasting blood sugar levels, creatinine, and plasma NGAL levels. All data were analyzed using the Statistical Package for Social Sciences (SPSS release 20.0, copyrite©SPSS Inc.) and a p-value < 0.05 was considered statistically significant.

RESULTS

In this study the plasma neutrophil gelatinase-associated lipocalin (NGAL) levels were significantly higher in cases compared to controls. Hypertensive cases also had significantly higher waist-circumference compared to the control group. The median fasting blood sugar level was significantly higher in cases compared to controls. This study established the use of Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Cockcroft and Gault formula (CG) as the most accurate predictive equations for assessing renal dysfunction. The threshold for NGAL above which renal impairment can be assessed was found to be 109.4 ng/ml (sen-91%, spec. - 68%), 120 ng/ml (sen- 100%, spec- 72%) and 118.6 ng/ml (sen- 83%, spec- 72%) for MDRD, CKD-EPI and CG equations respectively. The prevalence of CKD was 16.4%, 13.6% and 20.7% respectively using the MDRD, CKD-EPI and CG.

CONCLUSION

From this study, pNGAL is a better indicator of kidney impairment in the early stages of CKD as compared with sCr in general hypertensive population.

摘要

背景

肾衰竭是高血压最严重的血管效应之一。为了更好地治疗和预防并发症，绝对有必要在这些患者中早期发现肾脏疾病。然而，目前的研究提出，与血清肌酐（SCr）相比，血浆中性粒细胞明胶酶相关脂质运载蛋白（pNGAL）是一种更好的生物标志物。本研究评估了血浆中性粒细胞明胶酶相关脂质运载蛋白（pNGAL）作为高血压个体早期肾病诊断生物标志物的诊断效用。

方法

本项基于医院的病例对照研究纳入了 140 名高血压患者和 70 名健康参与者。使用结构化问卷和患者病历记录相关的人口统计学和临床信息。采集 5ml 静脉血样，测量空腹血糖水平、肌酐和血浆 NGAL 水平。所有数据均使用社会科学统计软件包（SPSS 版本 20.0，版权©SPSS Inc.）进行分析，p 值<0.05 被认为具有统计学意义。

结果

在这项研究中，与对照组相比，病例组的血浆中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平显著升高。高血压病例组的腰围也明显高于对照组。与对照组相比，病例组的空腹血糖水平显著升高。本研究确立了改良肾脏病饮食研究（MDRD）、慢性肾脏病流行病学合作（CKD-EPI）和 Cockcroft 和 Gault 公式（CG）作为评估肾功能障碍最准确的预测方程。发现 NGAL 的截断值为 109.4ng/ml（敏感性 91%，特异性 68%）、120ng/ml（敏感性 100%，特异性 72%）和 118.6ng/ml（敏感性 83%，特异性 72%），分别用于 MDRD、CKD-EPI 和 CG 方程，可以评估肾功能损害。使用 MDRD、CKD-EPI 和 CG 时，CKD 的患病率分别为 16.4%、13.6%和 20.7%。