陈正徐, 李曼, 袁润林, 金娟, 张白银, 郑元杰. 糖尿病肾病病人尿外泌体DPP-4、Cys C、α1-MG和转铁蛋白联合检测的临床价值[J]. 蚌埠医学院学报, 2021, 46(8): 1093-1095, 1098. DOI: 10.13898/j.cnki.issn.1000-2200.2021.08.027
    引用本文: 陈正徐, 李曼, 袁润林, 金娟, 张白银, 郑元杰. 糖尿病肾病病人尿外泌体DPP-4、Cys C、α1-MG和转铁蛋白联合检测的临床价值[J]. 蚌埠医学院学报, 2021, 46(8): 1093-1095, 1098. DOI: 10.13898/j.cnki.issn.1000-2200.2021.08.027
    CHEN Zheng-xu, LI Man, YUAN Run-lin, JIN Juan, ZHANG Bai-yin, ZHENG Yuan-jie. Clinical value of the combined detection of urinary exosome DPP-4, Cys C, α1-MG and transferrin in patients with diabetic nephropathy[J]. Journal of Bengbu Medical College, 2021, 46(8): 1093-1095, 1098. DOI: 10.13898/j.cnki.issn.1000-2200.2021.08.027
    Citation: CHEN Zheng-xu, LI Man, YUAN Run-lin, JIN Juan, ZHANG Bai-yin, ZHENG Yuan-jie. Clinical value of the combined detection of urinary exosome DPP-4, Cys C, α1-MG and transferrin in patients with diabetic nephropathy[J]. Journal of Bengbu Medical College, 2021, 46(8): 1093-1095, 1098. DOI: 10.13898/j.cnki.issn.1000-2200.2021.08.027

    糖尿病肾病病人尿外泌体DPP-4、Cys C、α1-MG和转铁蛋白联合检测的临床价值

    Clinical value of the combined detection of urinary exosome DPP-4, Cys C, α1-MG and transferrin in patients with diabetic nephropathy

    • 摘要:
      目的探讨糖尿病肾病病人尿外泌体二肽基肽酶-4(exosome-DPP-4)、胱抑素C(Cys C)、α1-微球蛋白(α1-MG)和尿转铁蛋白(TRU)联合检测的临床价值。
      方法检测40例健康对照组和120例糖尿病病人正常蛋白尿组(40例)、微量蛋白尿组(40例)和大量蛋白尿组(40例)尿外泌体DPP-4和尿Cys C、α1-MG、TRU、IgG、微量白蛋白水平,应用Pearson相关分析评价各项目间的相关性,采用受试者工作特征曲线评估DPP-4、Cys C、α1-MG、TRU、IgG等诊断糖尿病肾病的价值。
      结果糖尿病肾病病人尿液外泌体中的DPP-4、尿α1-MG含量高于对照组(P<0.05),且随着尿蛋白含量的增加而上升(P<0.05~P<0.01);Cys C、TRU、IgG水平在正常蛋白尿组与对照组差异无统计学意义(P>0.05),在微量蛋白尿组、大量蛋白尿组Cys C、TRU、IgG水平均高于对照组(P<0.05~P<0.01)。尿外泌体DPP-4与α1-MG、Cys C、TRU、IgG呈正相关关系(P<0.05)。DPP-4、α1-MG、Cys C、TRU、IgG以及DPP-4与α1-MG、Cys C、TRU联合检测水平的受试者工作特征曲线下面积为0.742、0.736、0.843、0.868、0.836和0.899;DPP-4、α1-MG、Cys C及TRU联合检测灵敏度为93.42%,特异度为86.90%,阳性预测值为86.59%,阴性预测值为93.59%。
      结论尿外泌体DPP-4、尿Cys C和尿α1-MG、TRU联合检测对糖尿病肾病的早期诊断具有较高的临床价值。

       

      Abstract:
      ObjectiveTo investigate the clinical value of the combined detection of urinary exosome dipeptidyl peptidase 4(DPP-4), α1-microglobulin(α1-MG), cystatin C(Cys C) and transferring(TRU) in patients with diabetic nephropathy.
      MethodsThe levels of DPP-4, α1-MG, Cys C, TRU, IgG, microalbuminuria in 120 diabetic patientsincluding normal proteinuria group(40 cases), microalbuminuria group(40 cases) and massive proteinuria group(40 cases) and healthy control group(40 cases) were detected.The Pearson correlation analysis was used to evaluate the correlation among the items.The receiver operating characteristic curve was used to evaluate the value of DPP-4, Cys C, α1-MG, TRU and IgG in the diagnosis of diabetic nephropathy.
      ResultsThe contents of DPP-4 and α1-MG in urine exosomes of diabetic nephropathy patients were higher than those in control group(P < 0.05), and increased with the increasig of urine protein content(P < 0.05 to P < 0.01).The differences of the levels of Cys C, TRU and IgG between normal albuminuria group and control group were not statistically significant(P>0.05), and the levels of Cys C, TRU and IgG in microalbuminuria group and massive albuminuria group were higher than those in control group(P < 0.05 to P < 0.01).The urinary exosome DPP-4 was positively correlated with α1-MG, Cys C, TRU and IgG(P < 0.05).The areas under the receiver operating characteristic curve of DPP-4, α1-MG, Cys C, TRU, IgG, and combined DPP-4, α1-MG, Cys C and TRU were 0.742, 0.736, 0.843, 0.868, 0.836 and 0.899, respectively.The sensitivity, specificity, positive predictive value and negative predictive value of the combined detection of DPP-4, α1-MG, Cys C and TRU were 93.42%, 86.90%, 86.59% and 93.59%, respectively.
      ConclusionsThe combined detection of urinary exosome DPP-4, urinary Cys C and urinary α1-MG and TRU has high clinical value in the early diagnosis of diabetic nephropathy.

       

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