| Objective:Diabetic nephropathy(DN),is one of the major chronic complications of diabetes.If not be diagnosed and treated early,DN often develops into end-stage renal disease,leading to death.Therefore,early diagnosis of DN can help guide clinical interventions to improve patient outcomes.However,the current diagnostic method for DN needs to be improved.Based on this,this study aims to investigate the diagnostic value of zinc-?-2-glycoprotein(zine-alpha-2-glycoprotein,ZAG),kidney injury molecule 1(kidney injury molecule-1,KIM-1)and neutrophil gelatinase-associated troponin(neutrophil gelatinase-associated lipocalin,NGAL))in urine and serum for the diagnosis of DN.Method: Selection of 120 patients with type 2 diabetes mellitus hospitalized in the department of endocrinology,Huaian No.1 Hospital affiliated to Nanjing Medical University between 2018.01-2018.12 were divided into three groups according to the morning urine albumin to creatinine ratio(UACR): diabetic control group(group B)(UACR<30mg/g),diabetes microalbuminuria group(group C)(UACR 30 ? 300mg/g),diabetic albumin group(group D)(UACR >300 mg/g),and 38 healthy subjects in the same period as normal controls group(Group A).The urine and blood of the patients was collected,and the concentrations of ZAG,KIM-1,and NGAL in urine and serum were detected by enzyme-linked immunosorbent assay(ELISA).The correlation between ZAG,KIM-1and NGAL and biochemical indicators were evaluated,and the value of combined detection of the three biomarker for the diagnosis of early DN were evaluated by ROC curve analysis.Results: 1.The concentrations of u ZAG,u KIM-1 and u NGAL in the urine of eachgroup were in turn:group A:14.4 ± 2.0?g/m L,40.7 ± 6.5ng/m L,21.1 ±5.2ng/m L;B:18.7 ± 2.4?g/m L,60.4 ± 17.5ng/m L,29.8 ± 7.7ng/m L;C:26.1±3.6?g/m L,112.8 ± 28.9ng/m L,47.6 ± 12.1ng/m L;D:35.4 ± 3.0?g/m L,171.3 ±24.1ng/m L,81.4 ± 10.8ng/m L.2.The concentrations of s ZAG,s KIM-1 and s NGAL in the serum of each group were in turn: group A:16.8 ± 3.0?g/m L,49.0±8.1ng/m L,29.9 ± 6.1ng/m L;B:22.8 ± 4.1?g/m L,66.1 ± 15.7ng/m L,39.8 ±9.3ng/m L;C:29.3 ± 4.4?g/m L,120.2 ± 33.2ng/m L,55.9 ± 11.1ng/m L;D:33.8 ±3.2?g/m L,180.3 ± 28.8ng/m L,87.7 ± 11.7ng/m L.3.The concentrations of ZAG,KIM-1 and NGAL were positively correlated with UACR,Um Alb and duration of diabetes,and ball filtration rate showed a negative correlation.4.The area under the ROC curve(AUC)for the respectively diagnosis of DN by u ZAG,u KIM-1 and u NGAL were 0.749,0.756 and 0.733;The AUC for the respectively diagnosis of DN by s ZAG,s KIM-1 and s NGAL were 0.719,0.708 and 0.725.5.The AUC of u KIM-1combined with u NGAL for the diagnosis of DNwas 0.809;the AUC of s KIM-1combined with s NGAL was 0.783;the AUC of u KIM-1 combined with u ZAG was0.813;the AUC of s KIM-1 combined with s ZAG was 0.743;the AUC of u NGAL combined with u ZAG was 0.852;the AUC of s NGAL combined with s ZAG was0.766;6.the AUC of combined diagnosis use u ZAG,u KIM-1 and u NGAL was 0.869;the AUC of combined diagnosis use s ZAG,s KIM-1 and s NGAL was 0.798.Conclusion: ZAG,KIM-1and NGAL in serum and urine can be used alone or in combination to diagnose DN;Compared with the combined detection of the three indicators in serum,the combined detection of the three indicators in urinein for the diagnosis of DN is of higher valuable. |
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