Evaluation of urinary biomarkers for prediction of diabetic kidney disease: a propensity score matching analysis
Evaluation of urinary biomarkers for prediction of diabetic kidney disease: a propensity score matching analysis
复制标题
预测糖尿病肾病的尿液生物标志物评估：倾向评分匹配分析
DOI：
10.1177/2042018819891110
复制
发表时间：
2019-11-01
影响因子：
3.8
通讯作者：
Chang, Baocheng
中科院分区：
文献类型：
--
作者：
Qin, Yongzhang;Zhang, Shuang;Chang, Baocheng
本研究旨在评价6种尿生物标志物对糖尿病肾病的诊断价值。方法收集1053例2型糖尿病( 2 DM)住院患者，按24 h尿白蛋白排泄率(24 H UAE)分为糖尿病(DM)伴正常白蛋白尿(NA)组(n= 753)和DKD组(n= 300)。测定尿转铁蛋白(Tf)、免疫球蛋白G(Ig G)、视黄醇结合蛋白(RBP)、β-半乳糖苷酶(GAL)、N-乙酰-β-氨基葡萄糖苷酶(NAG)和β-2-微球蛋白(β-2 MG)等6项尿液标志物的水平。采用倾向性评分匹配法(PSM)排除混杂变量的影响。结果DKD患者6项尿液标志物水平均较高。除GAL和β2 MG外，所有指标均显示患DKD的风险显著增加。单项RBP的曲线下面积(AUC值)最大，为0.920，其次是Tf(0.867)和Ig G(0.867)。然而，GAL、NAG和β-2 MG的预后能力较弱。结论RBP、Tf、Ig G可作为DKD的可靠或良好的预测指标。这些生物标志物的联合使用并没有改善DKD的检测。
BackgroundThe aim of this study was to evaluate the diagnostic value of six urinary biomarkers for prediction of diabetic kidney disease (DKD).MethodsThe cross-sectional study recruited 1053 hospitalized patients with type 2 diabetes mellitus (T2DM), who were categorized into the diabetes mellitus (DM) with normoalbuminuria (NA) group (n= 753) and DKD group (n= 300) according to 24-h urinary albumin excretion rate (24-h UAE). Data on the levels of six studied urinary biomarkers [transferrin (TF), immunoglobulin G (IgG), retinol-binding protein (RBP), β-galactosidase (GAL), N-acetyl-beta-glucosaminidase (NAG), and β2-microglobulin (β2MG)] were obtained. The propensity score matching (PSM) method was applied to eliminate the influences of confounding variables.ResultsPatients with DKD had higher levels of all six urinary biomarkers. All indicators demonstrated significantly increased risk of DKD, except for GAL and β2MG. Single RBP yielded the greatest area under the curve (AUC) value of 0.920 compared with the other five markers, followed by TF (0.867) and IgG (0.867). However, GAL, NAG, and β2MG were shown to have a weak prognostic ability. The diagnostic values of the different combinations were not superior to the single RBP.ConclusionsRBP, TF, and IgG could be used as reliable or good predictors of DKD. The combined use of these biomarkers did not improve DKD detection.