糖尿病肾病患者尿中性粒细胞明胶酶相关脂质运载蛋白的改变及其临床意义

目的 探讨糖尿病肾病患者尿中性粒细胞明胶酶相关脂质运载蛋白(uNGAL)的变化及其临床意义.方法 87例2型糖尿病(T2DM)患者根据尿微量白蛋白/尿肌酐比(uAlb/uCr)分为高白蛋白尿组(含大量和微量白蛋白尿患者:uAlb/uCr≥30 mg/mmol)和正常白蛋白尿组(uAlb/uCr＜30 mg/mmol)；另选择40例正常健康者作为对照,测定其uNGAL水平、血脂及血糖水平等.结果 uNGAL蛋白表达水平在对照组、正常白蛋白尿组和高白蛋白尿组中逐层递增,差异有统计学意义(P＜0.01)；检测各指标和糖尿病肾病进展程度的相关性,发现uAlb/uCr、uNGAL、空腹血糖(FBG)、三酰甘油(TG)的表达水平和疾病发展呈正相关(ruAlb/uCr=0.16,ruNGAL=0.18,rFBG =0.41,rTG=0.72,P均＜0.05),而高密度脂蛋白胆固醇(HDL-C)和疾病发展呈负相关(rHDL-C=-2.19,P＜0.01).结论 糖尿病肾病患者uNGAL水平增加,且与肾损伤程度相关,uNGAL可以作为糖尿病肾病早期诊断的指标；血糖及血脂控制不佳会加速糖尿病肾病的进程.

Changes of urine neutrophil gelatinase associated lipocalin in patients with diabetic nephropathy and the related clinical significance

Objective To investigate the changes of urine neutrophil gelatinase associated lipocalin(uNGAL) in patients with diabetic nephropathy(DN) and the related clinical significance.Methods Eighty-seven T2DM patients were divided into high albuminuria group(including both miroalbuminuria and clinical nephropathy patients,uAlb/uCr≥30 mg/mmol) and normal albuminuria(NA) group(uAlb/uCr<30 mg/mmol) according to the ratio of urinary albumin to urinary creatinine abundance.Forty normal subjects were recruited as control.The uNGAL level was measured by ELISA;plasma glucose,blood lipids(TC,TG,HDL-C,and LDL-C) abundance were also analyzed.Results The high albuminuria group had the highest uNGAL level,followed by normal albuminuria group and control group,and the former two groups had significantly higher uNGAL levels than the control group(P<0.01).Logistic regression analysis showed that uAlb/uCr,uNGAL,FBG and TG levels were positively correlated with the progress of DN(ruAlb/uCr= 0.16,ruNGAL=0.18,rFBG=0.41,and rTG=0.72,P<0.05);HDL-C was negatively correlated with the progress of DN(rHDL-C=-2.19,P<0.01).Conclusion uNGAL level is significantly increased in DN patients and correlated with the degree of kidney damage.uNGAL may serve as an indicator for early diagnosis of DN.The elevated plasma glucose and blood lipids can accelerate the progress of DN.