Chen Jin, Li Zhi-Yong, Xu Fei, Wang Chao-Qun, Li Wen-Wen, Lu Jin, Miao Chao-Yu
Department of Endocrinology and Metabolism, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, People's Republic of China.
Department of Pharmacology, Second Military Medical University/Naval Medical University, Shanghai, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Feb 27;17:959-967. doi: 10.2147/DMSO.S452055. eCollection 2024.
Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease. Metrnl is a secreted protein that plays an important role in kidney disease. The aim of this study was to investigate DKD-related factors and the correlation between serum Metrnl levels and the severity of DKD.
Ninety-six type 2 diabetes mellitus (T2DM) patients and 45 DKD patients were included in the study. A range of parameters were measured simultaneously, including waist-to-hip ratio (WHR), body mass index (BMI), urinary albumin/creatinine ratio (UACR), monocyte-lymphocyte ratio (MLR), albumin/globulin (A/G), liver and kidney function, blood lipid profile, islet function, and others. Subsequently, the related factors and predictive significance of DKD were identified. The correlation between the relevant factors of DKD and serum Metrnl levels with DKD was evaluated.
The duration of the disease (OR: 1.12, 95% CI: 1.01-1.24, =0.031), hypertension (OR: 4.86, 95% CI: 1.16-20.49, =0.031), fasting blood glucose (OR: 1.23, 95% CI: 1.03-1.48, =0.025), WHR (OR: 2.53, 95% CI: 1.03-6.22, =0.044), and MLR (OR: 1.91, 95% CI: 1.18-3.08, =0.008) are independent risk factors for DKD (P < 0.05). Conversely, A/G (OR: 0.13, 95% CI: 0.02-0.76, =0.024) and Metrnl (OR: 0.99, 95% CI: 0.98-1.00, =0.001) have been identified as protective factors against DKD. Furthermore, the level of Metrnl was negatively correlated with the severity of DKD (r=-0.447, <0.001). The area under receiver operating characteristic (ROC) curves for the diagnostic accuracy of Metrnl for DKD is 0.765 (95% CI: 0.686-0.844).
The duration of the disease, hypertension, fasting blood glucose, WHR, and MLR are major risk factors for DKD. Metrnl and A/G are protective factors for DKD. Serum Metrnl concentrations are inversely correlated with DKD severity.
糖尿病肾病（DKD）是终末期肾病的主要病因。Metrnl是一种分泌蛋白，在肾脏疾病中起重要作用。本研究旨在探讨与DKD相关的因素以及血清Metrnl水平与DKD严重程度之间的相关性。
本研究纳入了96例2型糖尿病（T2DM）患者和45例DKD患者。同时测量了一系列参数，包括腰臀比（WHR）、体重指数（BMI）、尿白蛋白/肌酐比值（UACR）、单核细胞与淋巴细胞比值（MLR）、白蛋白/球蛋白（A/G）、肝肾功能、血脂谱、胰岛功能等。随后，确定了DKD的相关因素及其预测意义。评估了DKD相关因素与血清Metrnl水平和DKD之间的相关性。
病程（OR：1.12，95%CI：1.01 - 1.24，P = 0.031）、高血压（OR：4.86，95%CI：1.16 - 20.49，P = 0.031）、空腹血糖（OR：1.23，95%CI：1.03 - 1.48，P = 0.025）、WHR（OR：2.53，95%CI：1.03 - 6.22，P = 0.044）和MLR（OR：1.91，95%CI：1.18 - 3.08，P = 0.008）是DKD的独立危险因素（P < 0.05）。相反，A/G（OR：0.13，95%CI：0.02 - 0.76，P = 0.024）和Metrnl（OR：0.99，95%CI：0.98 - 1.00，P = 0.001）已被确定为预防DKD的保护因素。此外，Metrnl水平与DKD严重程度呈负相关（r = -0.447，P < 0.001）。Metrnl对DKD诊断准确性的受试者工作特征（ROC）曲线下面积为0.765（95%CI：0.686 - 0.844）。
病程、高血压、空腹血糖、WHR和MLR是DKD的主要危险因素。Metrnl和A/G是DKD的保护因素。血清Metrnl浓度与DKD严重程度呈负相关。
