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中性粒细胞明胶酶相关脂质运载蛋白:作为2型糖尿病早期糖尿病肾病的预测指标

Neutrophil Gelatinase-associated Lipocalin: As a Predictor of Early Diabetic Nephropathy in Type 2 Diabetes Mellitus.

作者信息

Kaul A, Behera M R, Rai M K, Mishra P, Bhaduaria D S, Yadav S, Agarwal V, Karoli R, Prasad N, Gupta A, Sharma R K

机构信息

Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

出版信息

Indian J Nephrol. 2018 Jan-Feb;28(1):53-60. doi: 10.4103/ijn.IJN_96_17.

Abstract

This study was carried out to look for diagnostic and prognostic role of neutrophil gelatinase-associated lipocalin (NGAL) in early diabetic nephropathy (DN) in type 2 diabetes individuals. NGAL was measured in both urinary and serum sample of 144 type 2 diabetes individuals stratified into three categories based on urinary albumin-creatinine ratio and 54 control populations with estimated glomerular filtration rate >60 mL/min/1.73 m and serum creatinine <1.2 mg/dl. The serum NGAL (sNGAL), urine NGAL (uNGAL), and uNGAL/urine creatinine were significantly higher in diabetic individuals than in the control populations with significant difference in between the groups ( < 0.05). Difference of above values between control value and normoalbuminuria was also statistically significant ( < 0.05). Again, sNGAL and uNGAL correlate positively with albuminuria ( < 0.05). Tubular injury may precede glomerular injury in diabetic individuals, and NGAL can be used as a biomarker to diagnose DN even earlier to incipient nephropathy. Both sNGAL and uNGAL can predict albuminuria and be used as a noninvasive tool for diagnosis, staging, and progression of DN.

摘要

本研究旨在探寻中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在2型糖尿病患者早期糖尿病肾病(DN)中的诊断和预后作用。对144例2型糖尿病患者的尿液和血清样本进行了NGAL检测,这些患者根据尿白蛋白肌酐比值分为三类,同时检测了54名估计肾小球滤过率>60 mL/min/1.73 m²且血清肌酐<1.2 mg/dl的对照人群。糖尿病患者的血清NGAL(sNGAL)、尿NGAL(uNGAL)和uNGAL/尿肌酐显著高于对照人群,组间差异有统计学意义(P<0.05)。对照值与正常白蛋白尿之间上述值的差异也有统计学意义(P<0.05)。此外,sNGAL和uNGAL与蛋白尿呈正相关(P<0.05)。在糖尿病患者中,肾小管损伤可能先于肾小球损伤,NGAL可作为一种生物标志物,甚至在早期肾病阶段就能更早地诊断DN。sNGAL和uNGAL均可预测蛋白尿,并可作为DN诊断、分期和病情进展的非侵入性工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c31/5830810/8273703eade5/IJN-28-53-g002.jpg

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