Urinary Podocalyxin as a Biomarker to Diagnose Membranous Nephropathy.
Urinary Podocalyxin as a Biomarker to Diagnose Membranous Nephropathy.
复制标题
DOI：
10.1371/journal.pone.0163507
复制
发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Maruyama S
中科院分区：
文献类型：
--
作者：
Imaizumi T;Nakatochi M;Akiyama S;Yamaguchi M;Kurosawa H;Hirayama Y;Katsuno T;Tsuboi N;Hara M;Maruyama S
需要一种膜性肾病（MN）的非侵入性诊断标志物。在各种肾小球疾病（包括 MN）中，尿足萼蛋白 (PCX) 水平较高。本研究的目的是结合尿液PCX和临床参数构建MN的诊断模型。我们进行了这项横断面研究，利用名古屋大学及其附属医院多中心肾活检登记处的数据和样本构建 MN 的诊断模型。通过夹心 ELISA 测量尿 (u-) PCX。我们在105个训练样本中构建了3种类型的诊断模型：u-PCX单变量模型、u-PCX以外的临床参数的组合模型（临床模型）以及u-PCX和临床参数的组合模型（组合模型）。我们通过比较 209 个验证样本的 c 统计量和决策曲线分析 (DCA)，评估了诊断模型的临床实用性。临床模型包括年龄、肾小球滤过率和糖尿病。在训练队列中，组合模型的 c 统计量为 0.868 [95% CI，0.799–0.937]。在验证队列中，截止值的敏感性为 80.5%，特异性为 73.5%。在 DCA 中，组合模型的净效益在 40-80% 的阈值概率之间更好。在本研究中，我们通过将 u-PCX 与年龄、肾小球滤过率和糖尿病等临床参数相结合，证明了 u-PCX 作为 MN 诊断标志物的实用性以及诊断模型的临床实用性。
A non-invasive diagnostic marker of membranous nephropathy (MN) is desirable. The urinary level of podocalyxin (PCX) is higher in various glomerular diseases, including MN. The aim of this study was to construct a diagnostic model of MN with the combination of urinary PCX and clinical parameters. We performed this cross-sectional study to construct the diagnostic models for MN by using data and samples from the multicenter kidney biopsy registry of Nagoya University and its affiliated hospitals. Urinary (u-) PCX was measured by sandwich ELISA. We constructed 3 types of diagnostic models in 105 training samples: u-PCX univariate model, the combined model of clinical parameters other than u-PCX (clinical model), and the combined model of both u-PCX and clinical parameters (combined model). We assessed the clinical usefulness of the diagnostic models through the comparison of c-statistics and decision curve analysis (DCA) in 209 validation samples. The clinical model consisted of age, glomerular filtration rate, and diabetes mellitus. In the training cohort, the c-statistics were 0.868 [95% CI, 0.799–0.937] in the combined model. In the validation cohort, sensitivity was 80.5% and specificity was 73.5% on the cut-off value. The net benefit of the combined model was better between threshold probabilities of 40–80% in DCA. In this study, we demonstrated the utility of u-PCX as a diagnostic marker for MN and the clinical usefulness of the diagnostic models, through the combination of u-PCX and clinical parameters including age, glomerular filtration rate, and diabetes mellitus.
登录
查看更多内容
影响因子：
3.6
作者：
Vickers, Andrew J.;Elkin, Elena B.
通讯作者：
Elkin, Elena B.
影响因子：
13.2
作者：
Matsuo, Seiichi;Imai, Enyu;Hishida, Akira
通讯作者：
Hishida, Akira
影响因子：
3.3
作者：
Hara, Masanori;Yanagihara, Toshio;Kihara, Itaru
通讯作者：
Kihara, Itaru
影响因子：
6.1
作者：
Achenbach, Johannes;Mengel, Michael;Schiffer, Mario
通讯作者：
Schiffer, Mario
影响因子：
13.6
作者：
Hara, M;Yanagihara, T;Kajita, T
通讯作者：
Kajita, T