Departament of Health Management, Economics and Policy, School of Public Health, Augusta University, Augusta, GA, USA.
Department of Interdisciplinary Health Science, College of Allied Health Science, Augusta University, Augusta, GA, USA.
Sci Prog. 2024 Oct-Dec;107(4):368504241288776. doi: 10.1177/00368504241288776.
This retrospective study aimed to investigate the correlation between neutrophil gelatinase-associated lipocalin (NGAL) levels and the clinical progression and severity of diabetes-related acute kidney injury (AKI). The quantitative determination of NGAL in plasma on the Beckman Coulter AU480 analyzer was measured using the Bioporto NGAL Test, a particle-enhanced turbidimetric immunoassay with hospitalized patients at an East Central Georgia Medical Center.
The clinical determination of plasma NGAL included a retrospective cohort study where 45 adult patients were selectively recruited. The selective criteria were patients with and without diabetes mellitus (DM) at risk for developing AKI admitted to the Medical Center between January and November 2023. All patients included in the study had pNGAL levels measured upon admission and up to 96 h post-admission. Receiver operating characteristics and likelihood ratio methods were used to determine optimal sensitivity, specificity, and cutoff value of pNGAL in AKI patients associated with and without DM.
The intra-assay and interassay imprecision percent relative standard deviation was between 2.7% and 4.2%. pNGAL levels were higher for patients with AKI compared to non-AKI patients, regardless of DM status. The optimal cutoff value for pNGAL to predict AKI for patients with DM was 293 ng/mL, with a sensitivity of 80% and specificity of 87%. In a multivariate logistic regression model, pNGAL levels at 48 h post-admission were determined to be associated with diabetes-related AKI patients.
Plasma NGAL levels at 48 h are associated with patients with diabetes-related AKI. The specific cutoff values for AKI for early diagnosis and risk stratification and its association with comorbidities must be determined to improve patient outcomes.
本回顾性研究旨在探讨中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平与糖尿病相关急性肾损伤（AKI）的临床进展和严重程度之间的相关性。采用贝克曼库尔特 AU480 分析仪上的 Bioporto NGAL 测试，通过颗粒增强比浊免疫测定法对住院患者的血浆 NGAL 进行定量测定。
临床测定血浆 NGAL 包括一项回顾性队列研究，其中选择性招募了 45 名成年患者。选择标准为 2023 年 1 月至 11 月期间入住中东部佐治亚医疗中心有发生 AKI 风险的伴或不伴糖尿病（DM）的患者。所有纳入研究的患者在入院时和入院后 96 小时内均测量了 pNGAL 水平。采用受试者工作特征和似然比方法确定与 DM 相关和不相关 AKI 患者的 pNGAL 的最佳灵敏度、特异性和截止值。
批内和批间相对标准偏差的精密度百分比为 2.7%至 4.2%。无论 DM 状态如何，AKI 患者的 pNGAL 水平均高于非 AKI 患者。DM 患者预测 AKI 的最佳 pNGAL 截止值为 293ng/mL，灵敏度为 80%，特异性为 87%。在多变量逻辑回归模型中，入院后 48 小时的 pNGAL 水平与糖尿病相关 AKI 患者相关。
入院后 48 小时的血浆 NGAL 水平与糖尿病相关 AKI 患者相关。为了改善患者预后，必须确定用于早期诊断和风险分层的 AKI 的具体截止值及其与合并症的关系。
