联合检测视黄醇结合蛋白和膜联蛋白A2水平对糖尿病肾病早期诊断的意义

目的 探讨检测视黄醇结合蛋白和膜联蛋白A2水平对糖尿病患者早期肾损伤诊断的意义。方法 选取80例糖尿病肾病患者,以24-UAER含量为标准由低到高将患者分为A组(25例)、B组(26例)和C组(29例),另选体检者25例作为对照组(NC),测定所有研究对象糖化血红蛋白(HbAlc)、血肌酐(Scr)、尿素氮(BUN)、尿酸(UA)和视黄醇结合蛋白(RBP)水平。实时荧光定量PCR检测膜联蛋白A2(AnnexinA2)表达水平。结果 ①病例组(A+B+C)的HbAlc,Scr,BUN,UA和RBP水平均高于对照组(t=4.64～13.65,均P<0.05); A组和B组HbAlc,Scr,BUN和UA水平比较差异无统计学意义(t=0.31～1.25,均P>0.05),而RBP水平差异有统计学意义(t=15.26,P<0.05)。A组和C组Scr,BUN,UA和RBP水平比较差异有统计学意义(t=5.26～25.33,均P<0.05)。B组和C组Scr,BUN,UA和RBP水平比较差异也有统计学意义(t=4.02～18.33,均P<0.05); ②病例组(A+B+C组)AnnexinA2表达水平1.58±0.05 ng/ml,对照组为0.13±0.01 ng/ml,两组比较差异有统计学意义(t=18.45,P<0.05)。病例组A组0.12±0.01 ng/ml,B组1.35±0.06 ng/ml,C组1.88±0.07 ng/ml,两两比较差异有统计学意义(t=13.45～24.25,均P<0.05)。③糖尿病肾病组(A+B+C)患者RBP水平与AnnexinA2表达程度之间存在正相关(r=0.95,P<0.01)。结论联合检测血清视黄醇结合蛋白和膜联蛋白A2是反映糖尿病患者早期肾病微血管病变的敏感指标。

Significance of Combined Detection of Serum Retinol-Binding Protein and AnnexinA2 in Diabetic Nephropathy

Objective To explore the significance of detection serum Retinol-Binding Protein and AnnexinA2 in diabetic nephropathy.Methods According to 24-UAER level,80 diabetic patients withsuspected DN were devided into three groups,that was A(25 cases),B(26 cases)and C(29 cases)group,and control group(NC)was 25 cases.HbA1c,BUN,Scr,UA and RBP leves were detected by the standard method.The expression level of Annexin A2 were detected by real-time PCR.Results Therewere obvious differences of HbA1c,BUN,Scr,UA and RBP levels among three groups and NC group(t=4.64～13.65,P<0.05),To HbA1c,BUN,Scr and UA,no differences between A group and B groups(t=0.31～1.25,P>0.05),there weredifferences of RBP(t=15.26,P<0.05).To HbA1c,BUN,Scr UA and RBP,there were differences between A groups and C groups(t=5.26～25.33,P<0.05),there were the same results between B groups and C groups(t=4.02～18.33,P<0.05).To expression level of AnnexinA2 there were differences among threegroup and NC group((t=13.45～24.25,P<0.05)).There exist positive correlation between the expression of AnnexinA2 and RBP level(r=0.95,P<0.01).Conclusion Combined detection of serum RBP and expression level of AnnexinA2 may be a sensitive and early phase indicator for impairment of renal function for diagnosis of diabetic nephropathy.