MCP-1、MIF和ICAM-1在2型糖尿病肾病患者中的预测和诊断价值。
Predictive and diagnostic value of MCP-1, MIF, and ICAM-1 in Type-2 diabetes mellitus patients with diabetic kidney disease.
作者信息
Wang Yingying, Cheng Gang, Wang Gouqin, Zhou Xiaochun, Ma Min, Wang Jianqin
机构信息
Yingying Wang Department of Nephrology, The Second Hospital & Clinical Medical School, Lanzhou University; The Second Hospital & Clinical Medical School, Key laboratory of Nephropathy, The Second Hospital & Clinical Medical School, Lanzhou University, Nephropathy Clinical Medical Research Center, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu, People's Republic of China.
Gang Cheng Department of Nephrology, The Second Hospital & Clinical Medical School, Lanzhou University, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu, People's Republic of China.
出版信息
Pak J Med Sci. 2025 Jul;41(7):1943-1948. doi: 10.12669/pjms.41.7.12283.
OBJECTIVE
To explore the predictive value of monocyte chemoattractant protein-1 (MCP-1), macrophage migration inhibitory factor (MIF), and intercellular adhesion molecule-1 (ICAM-1) in patients with Type-2 diabetes mellitus (T2DM) complicated by diabetic kidney disease (DKD).
METHODS
This cross-sectional retrospective study included T2DN patients admitted to the Nephrology Department of Lanzhou University Second Hospital from September, 2022 to March, 2024. DKD was assessed by measuring the ratio of urinary albumin to creatinine. A Receiver Operating Characteristic (ROC) analysis was performed to evaluate the predictive value of MCP-1, MIF, and ICAM-1 for DKD.
RESULTS
A total of 241 patients were included, predominantly 158 males (65.6%), with a median age of 60 (53-69) years. Sixty-seven patients had no DKD (normal proteinuria), while 174 patients presented with DKD; of them, 95 cases had microalbuminuria, and 79 cases had high proteinuria. The MCP-1, MIF, and ICAM-1 levels in the high-proteinuria group were significantly higher than in other groups (all P<0.05). The multivariate logistic regression analysis showed that high levels of MCP-1, MIF, and ICAM-1 are risk factors for the development of DKD. ROC analysis demonstrated that the area under the curve (AUC) of MCP-1, MIF, and ICAM-1 for diagnosing DKD were 0.895 (95% CI: 0.857-0.933, P<0.001), 0.719 (95% CI: 0.653-0.785, P<0.001), and 0.827 (95% CI: 0.773-0.880, P<0.001), respectively. The combined prediction of DKD by the three factors was 0.941 (95% CI: 0.914-0.968, P<0.001).
CONCLUSIONS
MCP-1, MIF, and ICAM-1 are risk factors for developing DKD. A combination of these indexes may have a good predictive value for DKD.
目的
探讨单核细胞趋化蛋白-1（MCP-1）、巨噬细胞移动抑制因子（MIF）和细胞间黏附分子-1（ICAM-1）在2型糖尿病（T2DM）合并糖尿病肾病（DKD）患者中的预测价值。
方法
本横断面回顾性研究纳入了2022年9月至2024年3月在兰州大学第二医院肾内科住院的T2DM患者。通过测量尿白蛋白与肌酐比值评估DKD。采用受试者工作特征（ROC）分析评估MCP-1、MIF和ICAM-1对DKD的预测价值。
结果
共纳入241例患者，以158例男性为主（65.6%），中位年龄为60（53 - 69）岁。67例患者无DKD（蛋白尿正常），174例患者患有DKD；其中，95例为微量白蛋白尿，79例为大量蛋白尿。大量蛋白尿组的MCP-1、MIF和ICAM-1水平显著高于其他组（均P<0.05）。多因素logistic回归分析显示，MCP-1、MIF和ICAM-1水平升高是DKD发生的危险因素。ROC分析表明，MCP-1、MIF和ICAM-1诊断DKD的曲线下面积（AUC）分别为0.895（95%CI：0.857 - 0.933，P<0.001）、0.719（95%CI：0.653 - 0.785，P<0.001）和0.827（95%CI：0.773 - 0.880，P<0.001）。这三个因素联合预测DKD的AUC为0.941（95%CI：0.914 - 0.968，P<0.001）。
结论
MCP-1、MIF和ICAM-1是DKD发生的危险因素。这些指标联合应用可能对DKD具有良好的预测价值。
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