[1]梁雅灵,杨茂君,李衍辉,等.尿L-FABP、KIM-1、NGAL和血清cystatin C 在糖尿病肾病中的变化及意义[J].国际内分泌代谢杂志,2016,36(02):92-95,100.[doi:10.3760/cma.j.issn.1673-4157.2016.02.005]
　Liang Yaling,Yang Maojun,Li Yanhui,et al.Changes of urinary L-FABP, KIM-1, NGAL and serum cystatin C in diabetic nephropathy and its clinical value[J].International Journal of Endocrinology and Metabolism,2016,36(02):92-95,100.[doi:10.3760/cma.j.issn.1673-4157.2016.02.005]
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尿L-FABP、KIM-1、NGAL和血清cystatin C 在糖尿病肾病中的变化及意义()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
36
期数:
2016年02期
页码:
92-95,100
栏目:
论著
出版日期:
2016-03-20

文章信息/Info

Title:
Changes of urinary L-FABP, KIM-1, NGAL and serum cystatin C in diabetic nephropathy and its clinical value
作者:
梁雅灵; 杨茂君; 李衍辉; 黎秋晗; 黄炜; 徐勇
646000 泸州,四川医科大学附属医院内分泌科
Author(s):
Liang Yaling;  Yang Maojun;  Li Yanhui;  Li Qiuhan;  Huang Wei; Xu Yong.
Department of Endocrinology, Affiliated Hospital of Sichuan Medical University, Luzhou 646000,China
关键词:
糖尿病肾病;  肝型脂肪酸结合蛋白;  肾损伤分子-1;  中性粒细胞明胶酶相关载脂蛋白;  血清cystatin C
Keywords:
Diabetic nephropathy;  Liver-type fatty acid binding protein;  Kidney injury molecule-1;  Neutrophil gelatinase-associated lipocalin;  Serum cystatin C
DOI:
10.3760/cma.j.issn.1673-4157.2016.02.005
摘要:
目的 探讨尿液肝型脂肪酸结合蛋白(L-FABP)、肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关载脂蛋白(NGAL)和血清半胱氨酸蛋白酶抑制剂(cystatin)C水平在糖尿病肾病患者中的改变以及临床意义。方法 纳入2011年10月至2012年10月泸州医学院附属医院内分泌科确诊为2型糖尿病(T2DM)的住院患者118例,根据尿微量白蛋白/肌酐比值(UACR)分为正常白蛋白尿组(n=45)、微量白蛋白尿组(n=42)以及大量白蛋白尿组(n=31)。同时选择同期健康体检者41名作为正常对照组。采用ELISA法检测尿L-FABP、KIM-1和NGAL,免疫比浊法检测血清cystatin C。所有尿液检测指标经尿肌酐校正,比较各组间各标志物的变化情况及与UACR、估计的肾小球滤过率(eGFR)的相关性。结果 与正常对照组相比,糖尿病各组尿L-FABP和血清cystatin C水平明显升高,(χ2 =77.959,104.003,P均<0.05); 尿KIM-1水平亦明显升高(χ2 =29.711, P<0.05)。微量白蛋白尿组与大量白蛋白尿组尿NGAL水平较正常对照组和正常白蛋白尿组明显升高(χ2 =23.833,P<0.05),但在正常白蛋白尿组与正常对照组间未见明显变化。尿L-FABP、KIM-1、NGAL及血清cystatin C与UACR呈正相关(r=0.719,0.427,0.327,0.726,P均<0.01); 仅L-FABP、血清cystatin C与eGFR呈负相关(r=-0.301、-0.791,P<0.01)。结论 尿L-FABP、KIM-1、NGAL和血清cystatin C 在糖尿病肾病早期显著升高,其中尿L-FABP和血清cystatin C可能是反映糖尿病肾损伤较好的生物学指标。
Abstract:
Objective To investigate the changes of urinary liver-type fatty acid binding protein(L-FABP), kidney injury molecule-1(KIM-1), neutrophil gelatinase-associated lipocalin(NGAL)and serum cystatin C in diabetic nephropathy and its clinical value. Methods A total of 118 patients diagnosed with type 2 diabetes in the Department of Endocrinology of Affiliated Hospital of Sichuan Medical University from October 2011 to October 2012 were recruited in this study. According to their urinary albumin-to-creatinine ratio(UACR), patients were divided into normal albuminuria group(n=45), microalbuminuria group(n=42), and macroalbuminuria group(n=43). A total of 41 healthy subjects were enrolled as normal control group(n=41). Enzyme-linked immunosorbent assays were used to measure the levels of urinary L-FABP, KIM-1 and NGAL.Turbidimetric inhibition immuno-assay was used to measure the expression of serum cystatin C. All the urinary indicators were adjusted by the level of urine creatinine. Changes of biomarkers in each group and their crrelations between UACR, eGFR were also compared. Results Compared with normal control group, urinary L-FABP and serum cystatin C were significantly increased in diabetic groups(χ2=77.959,104.003,all P<0.05); urinary KIM-1 was also significantly increased(χ2=29.711,P<0.05). Urinary NGAL was increased in microalbuminuria group and macroalbuminuria group compared with normal control group and normal albuminuria group(χ2 =23.833, P<0.05), but there were no significant difference between normal albuminuria group and normal control group. Urinary L-FABP, KIM-1, NGAL and serum cystatin C were positively correlated with UACR(r=0.719, 0.427, 0.327, 0.726, all P<0.01); while L-FABP and serum cystatin C were negatively correlated with eGFR(r=-0.301,-0.791, all P<0.01). Conclusion Urinary L-FABP, KIM-1, NGAL and serum cystatin C are increased in early diabetic nephropathy, while urinary L-FABP and serum cystatin C may be the better biomarkers to predict diabetic renal injury.

参考文献/References:

[1] Stanton RC. Clinical challenges in diagnosis and management of diabetic kidney disease[J].Am J Kidney Dis, 2014,63(2 Suppl 2):S3-S21.DOI:10.1053/j.ajkd.2013.10.050.
[2] Xu Y, Xie Y, Shao X,et al. L-FABP: a novel biomarker of kidney disease[J]. Clin Chim Acta, 2015,445: 85-90.DOI:10.1016/j.cca.2015.03.017.
[3] Tu Y, Wang H, Sun R,et al. Urinary netrin-1 and KIM-1 as early biomarkers for septic acute kidney injury[J].Ren Fail,2014,36(10):1559-1563.DOI:10.3109/0886022X.2014.949764.
[4] Antonucci E, Lippi G, Ticinesi A,et al. Neutrophil gelatinase-associated lipocalin(NGAL): a promising biomarker for the early diagnosis of acute kidney injury(AKI)[J].Acta Biomed,2014,85(3):289-294.
[5] Murty MS, Sharma UK, Pandey VB, et al. Serum cystatin C as a marker of renal function in detection of early acute kidney injury[J].Indian J Nephrol,2013,23(3):180-183.DOI:10.4103/0971-4065.111840.
[6] Zhang L, Wang F, Wang L,et al. Prevalence of chronic kidney disease in China: a cross-sectional survey[J].Lancet, 2012,379(9818):815-822.DOI:10.1016/S0140-6736(12)60033-60036.
[8] Kamijo-Ikemori A, Sugaya T, Kimura K. L-type fatty acid binding protein(L-FABP)and kidney disease[J]. Rinsho Byori, 2014,62(2):163-170.
[9] von Eynatten M, Baumann M, Heemann U, et al.Urinary L-FABP and anaemia: distinct roles of urinary markers in type 2 diabetes[J].Eur J Clin Invest,2010,40(2):95-102.DOI:10.1111/j.1365-2362.2009.02220.x.
[10] Weinert LS, Prates AB, do Amaral FB, et al. Gender does not influence cystatin C concentrations in healthy volunteers[J].Clin Chem Lab Med,2010,48(3):405-408. DOI: 10.1515/CCLM.2010.068.
[11] Cruz DN, Goh CY, Haase-Fielitz A,et al. Early biomarkers of renal injury[J].Congest Heart Fail,2010,(Suppl 1):S25-S31. DOI: 10.1111/j.1751-7133.2010.00163.x.
[12] Vaidya VS, Niewczas MA, Ficociello LH,et al.Regression of microalbuminuria in type 1 diabetes is associated with lower levels of urinary tubular injury biomarkers, kidney injury molecule-1, and N-acetyl-β-D-glucosaminidase[J].Kidney Int, 2011,79(4):464-470. DOI: 10.1038/ki.2010.404.
[13] 张虹,童俊容,王寅,等. 中性粒细胞明胶酶相关载脂蛋白与 IgA肾病早期诊断及病理分级的关系[J].中国全科医学,2012,15(3): 868.
[14] Kuwabara T, Mori K, Mukoyama M,et al. Urinary neutrophil gelatinase-associated lipocalin levels reflect damage to glomeruli, proximal tubules, and distal nephrons[J].Kidney Int,2009,75(3):285-294.DOI: 10.1038/ki.2008.499.

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备注/Memo

备注/Memo:
基金项目:四川省教育厅重点项目(10ZA036); 四川省国际合作项目(14GH0003)
更新日期/Last Update: 2016-03-20