2型糖尿病患者血清淀粉样蛋白A、血清铁蛋白水平与糖尿病肾病的相关性研究

目的 探究2型糖尿病（T2DM）患者血清淀粉样蛋白A（SAA）、血清铁蛋白（SF）水平与糖尿病肾病（DKD）的相关性。方法 随机选取2017年3月—2018年9月江阴市人民医院DKD患者60例为研究组，同期该院T2DM不合并DKD患者60例为对照组，另选取健康者60例作为健康组。检测、计算并比较每位患者的尿白蛋白与尿肌酐比值（UACR）和肾小球滤过率（eGFR）。检测血清中SF及SAA水平。采用Spearman法分析患者血清SF、SAA水平与eGFR或UACR的相关性。采用Logistic多元回归模型分析SF、SAA水平与DKD的关系。结果 研究组血清SF及SAA水平高于对照组和健康组（P?<0.05），对照组血清SF及SAA水平高于健康组（P?<0.05）。血清SF、SAA分别与UACR呈正相关（rs?=0.495和0.506，均P?=0.000），与eGFR呈负相关（rs?=-0.421和-0.434，P?=0.002和0.001）。Logistic回归分析结果显示，SF、SAA水平高是DKD的危险因素（P?<0.05）。受试者工作特征（ROC）曲线分析显示，eGFR检测DKD的曲线下面积（AUC）为0.675（95% CI：0.465，0.884），敏感性和特异性分别为72.8%（95% CI：69.2，74.5）和80.2%（95% CI：78.6，81.3）；UACR检测DKD的AUC为0.814（95% CI：0.650，0.977），敏感性和特异性分别为74.6%（95% CI：71.3，76.8）和82.4%（95% CI：80.4，84.7）；SF+SAA联合检测DKD的AUC为0.950（95% CI：0.875，1.000），敏感性和特异性分别为82.1%（95% CI：79.5，84.9）和90.1%（95% CI：88.5，92.2）。SF+SAA联合检测的诊断价值高于eGFR和UACR检测。结论 SF和SAA在一定程度上可以反映eGFR，两者联合检测可作为DKD早期诊断的方法。

Study on correlation between SAA, SF levels and diabetic nephropathy in patients with type 2 diabetes mellitus

Objective To explore the correlation between serum amyloid A protein (SAA), serum ferritin (SF) and diabetic nephropathy (DKD) in patients with type 2 diabetes mellitus (T2DM). Methods Sixty patients with DKD between March 2017 and September 2018 were enrolled in the study group. In the same period, 60 patients with T2DM without DKD were in the control group, and 60 healthy subjects were included in the healthy group. The urinary albumin/creatinine ratio (UACR) and glomerular filtration rate (eGFR) were measured, calculated, and compared for each patient. Serum levels of SF and SAA were measured. Spearman correlation analysis was used to analyze the correlation between serum SF, SAA levels and eGFR or UACR. Logistic multiple regression analysis was used to analyze the relationship between SF, SAA levels and DKD. Results Serum SF and SAA in the study group were significantly higher than those in the control group and healthy group (P?