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唾液、血清和尿液中缺血修饰白蛋白(IMA)与儿童慢性肾脏病(CKD)诊断的相关性:病例对照研究。

Association of Ischemia-Modified Albumin (IMA) in Saliva, Serum, and Urine with Diagnosis of Chronic Kidney Disease (CKD) in Children: A Case-Control Study.

机构信息

Department of Conservative Dentistry, Medical University of Białystok, Białystok, Poland.

Department of Pediatrics and Nephrology, Medical University of Białystok, Białystok, Poland.

出版信息

Med Sci Monit. 2023 Dec 14;29:e942230. doi: 10.12659/MSM.942230.

Abstract

BACKGROUND Ischemia-modified albumin (IMA) is a secreted biomarker for ischemic oxidative stress. This case-control study aimed to evaluate the association of ischemia-modified albumin (IMA) in saliva, serum, and urine with diagnosis of chronic kidney disease (CKD) in 24 children. MATERIAL AND METHODS The study involved 24 children with CKD. CKD was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) diagnostic criteria. The control group consisted of 24 healthy children who were matched for age and gender to the experimental group. The concentration of IMA was determined by the colorimetric method in non-stimulated whole saliva (NWS), stimulated whole saliva (SWS), serum, and urine of children with CKD. The Mann-Whitney U test was used for inter-group comparisons. RESULTS IMA levels were significantly higher in NWS (P=0.0082) and SWS (P=0.0014) of children with CKD than in the control group. The concentration of IMA in NWS was correlated with standard indicators of kidney function, including the estimated glomerular filtration rate (r=-0.798, P≤0.0001), stage of CKD (r=0.814, P≤0.0001), and serum creatinine (r=0.711, P≤0.0001) and urea levels (r=0.738, P≤0.0001). CONCLUSIONS Salivary IMA concentration depends on renal function in children. Salivary IMA discriminates children with end-stage kidney disease from children with mild and moderate CKD and healthy children with high sensitivity and specificity. Further research is required, including assessment of the diagnostic usefulness and validation of the biomarker in a clinical diagnostic study.

摘要

背景

缺血修饰白蛋白(IMA)是一种缺血性氧化应激的分泌生物标志物。本病例对照研究旨在评估唾液、血清和尿液中的缺血修饰白蛋白(IMA)与 24 例儿童慢性肾脏病(CKD)的诊断之间的关系。

材料和方法

本研究纳入了 24 例 CKD 患儿。CKD 根据肾脏疾病改善全球结局(KDIGO)诊断标准定义。对照组由 24 名年龄和性别与实验组匹配的健康儿童组成。通过比色法测定 IMA 在非刺激全唾液(NWS)、刺激全唾液(SWS)、血清和尿液中的浓度。采用 Mann-Whitney U 检验进行组间比较。

结果

CKD 患儿的 NWS(P=0.0082)和 SWS(P=0.0014)中 IMA 水平显著高于对照组。NWS 中 IMA 浓度与肾功能标准指标相关,包括估算肾小球滤过率(r=-0.798,P≤0.0001)、CKD 分期(r=0.814,P≤0.0001)、血清肌酐(r=0.711,P≤0.0001)和尿素水平(r=0.738,P≤0.0001)。

结论

唾液中 IMA 浓度取决于儿童的肾功能。唾液 IMA 可高灵敏度和特异性地区分终末期肾病患儿、轻中度 CKD 患儿和健康儿童。需要进一步研究,包括评估该生物标志物的诊断有用性并在临床诊断研究中验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b23/10729497/5ca2c1f86b25/medscimonit-29-e942230-g001.jpg

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