NGAL滤过分数在2型糖尿病患者中的临床意义

目的研究中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在2型糖尿病患者血、尿中的表达，探讨其滤过分数在2型糖尿病患者中的临床意义。方法选择2型糖尿病患者118例及正常对照28例，根据尿白蛋白／肌酐比值（UACR）将患者分为三组，即UACR〈30mg／g的正常蛋白尿组64例，30mg／g≤UACR〈300m晚的微量白蛋白尿组36例，UACR≥300mg／g的大量白蛋白尿组18例。应用ELISA法测定各组血、尿中的NGAL的含量，常规方法测定血、尿肌酐等其它常用临床指标，按照BdignanoD提出公式计算NGAL滤过分数（FeNGAL），按照Macisaac公式估算GFR，统计分析FeNGAL与常用临床指标的相关性。结果（1）DM患者FeNGAL均明显高于正常对照组；三组间呈递增改变且差异有显著性（P〈0．05）;（2）FeNGAL与胱抑素C、UACR成正相关（R分别为0．279，0．485），与eGFR成负相关（R=-0．235）。结论FeNGAL可早期反映DM患者肾脏损害程度，且优于尿微量白蛋白及单一血、尿NGAL。

The clinic value of the fractional excretion rate of NGAL in type-2 diabetes patients

Objective To investigate the expression of neutrophil gelatinase-associated lipocalin(NGAL) in the urine and plasma of type-2 diabetes patients,to analyze the value of the fractional excretion rate of NGAL(Fe NGAL).Methods 118 cases with T2DM and 28 control subjects wereselected.The DM cases were divided into 3 groups according to urine albumin/creatinine ratio(UACR):64cases in normal albuminuria group,36 cases in microalbuminuria group,and 18 cases in macroalbuminuria group,respectively.Urinary and plasma NGAL were measured by ELISA.Fasting glucose,serum cystatin C(Cysc),glycohemoglobinA1c (HbA1c) were also measured.Fe NGAL was determined by Bolignano D formulae; Glomerular filtration rate (GFR) determined by Macisaac formulae.Results (1)Fe NGAL in T2DM was significantly higher,comparing with the controls; significant difference was also found among the three groups ( P＜0.05 ).(2) Fe NGAL was positively corelated with Cys C and UACR(R=0.279,0.485),but inversely corelated with GFR(R=-0.235).Conclusion Fe NGAL can reflect the damage of T2DM earlier than urine albumin or Urinary NGAL.