尿NGAL、L-FABP及RBP与老年2型糖尿病肾病的相关性研究

目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肝型脂肪酸结合蛋白(L-FABP)及视黄醇结合蛋白(RBP)在老年2型糖尿病肾病(DKD)患者中的变化,及与尿微量清蛋白/肌酐比值(UACR)和估算的肾小球滤过率(eGFR)的相关性。方法选取2017年1月至2018年3月该院收治的老年2型DKD患者184例,根据UACR分为尿蛋白正常组(n=68)、微量清蛋白尿组(n=66)及大量清蛋白尿组(n=50),另选取同期体检健康者60例作为健康对照组。采用酶联免疫吸附测定检测各组尿NGAL、L-FABP及RBP水平。Pearson相关分析尿NGAL、L-FABP及RBP水平与UACR、eGFR的相关性。结果尿蛋白正常组、微量清蛋白尿组和大量清蛋白尿组尿NGAL、L-FABP及RBP水平明显高于健康对照组(P<0.05),微量清蛋白尿组尿NGAL、L-FABP及RBP水平明显高于尿蛋白正常组(P<0.05),大量清蛋白尿组尿NGAL、L-FABP及RBP水平明显高于尿蛋白正常组和微量清蛋白尿组(P<0.05)。相关性分析显示,老年2型DKD患者尿NGAL、L-FABP及RBP水平与UACR均呈正相关(r=0.542、0.826、0.706,P<0.01),尿NGAL、L-FABP及RBP水平与eGFR均呈负相关(r=-0.483、-0.607、-0.635,P<0.01)。结论尿NGAL、L-FABP及RBP水平在老年2型DKD患者中明显升高,与2型DKD患者的发生、发展密切相关。

The correlation between urinary NGAL,L-FABP,RBP and type 2 diabetic kidney disease in elderly patients

Objective To investigate the changes of urinary neutrophil gelatinase-associated lipid carrier protein(NGAL),liver-type fattyacid binding protein(L-FABP)and retinol binding protein(RBP)in patients with type 2 diabetic kidney disease(DKD),and their correlation with urinary microalbumin-creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR).Methods A total of 184 patients with type 2 DKD admitted and treated in the hospital from January 2017 to March 2018 were enrolled in the study.According to UACR,they were divided into normal urinary protein group(n=68),microalbuminuria group(n=66)and severe albuminuria group(n=50).Another 60 healthy people who had physical examination at the same time were selected as the healthy control group.Urinary NGAL,L-FABP and RBP levels were measured by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between urinary NGAL,L-FABP and RBP levels and UACR,eGFR.Results The urinary NGAL,L-FABP and RBP levels in normal urinary protein group,microalbuminuria group and severe albuminuria group were significantly higher than those in healthy control group(P<0.05).The levels of urine NGAL,L-FABP and RBP in the microalbuminuria group were significantly higher than those in the normal urinary protein group(P<0.05).Urinary NGAL,L-FABP and RBP levels in severe albuminuria group were significantly higher than those in urinary protein group and microalbuminuria group(P<0.05).Correlation analysis showed that urinary NGAL,L-FABP and RBP levels were positively correlated with UACR(r=0.542,0.826,0.706,P<0.05),and urinary NGAL,L-FABP and RBP levels were negatively correlated with eGFR(r=-0.483,-0.607,-0.635,P<0.01).Conclusion Urinary NGAL,L-FABP and RBP levels are significantly elevated in type 2 DKD patients,which is closely related to the occurrence and development of type 2 DKD patients.