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投稿时间：2024-12-09 网络发布日期：2025-09-19
投稿时间：2024-12-09 网络发布日期：2025-09-19
中文摘要: 目的 探究糖尿病肾病（DKD）患者血清β-痕迹蛋白（βTP）和E-钙黏蛋白（E-Cadherin）的水平，评估二者单独或联合对DKD的早期诊断价值。方法 前瞻性选取2024年1月至2024年8月长沙市第三医院诊治的DKD患者150例（DKD组），另按1∶1比例选取同期单纯糖尿病（DM）患者150例（DM组）。根据尿白蛋白/尿肌酐比值（UACR）将DKD组患者分为早期组（30mg/g≤UACR<300 mg/g，n=84）和临床组（UACR≥300 mg/g，n= 66）。收集研究对象临床资料，采用酶联免疫吸附法（ELISA）检测血清βTP和E-Cadherin水平。采用多因素logistic回归分析筛选DKD发生的危险因素。绘制受试者工作特征曲线（ROC）评估血清βTP和E-Cadherin水平单独及联合对DKD的预测价值。结果 DKD组和DM组患者收缩压（SBP）、总胆固醇（TC）、三酰甘油（TG）、糖化血红蛋白（HbA1C）、尿白蛋白排泄率（UAER）水平比较，差异有统计学意义（P＜0.01）。与DM组比较，DKD组患者血清βTP水平高［（0.99±0.43）mg/L vs（0.57±0.19）mg/L，t= 10.857，P＜0.001］，血清E-Cadherin水平低［（14.80±4.36）ng/mL vs（23.60±7.30）ng/mL，t= 12.685，P＜0.001］。与早期组比较，临床组患者血清βTP水平高［（1.24±0.38）mg/L vs（0.79±0.36）mg/L，t= 7.333，P＜0.001］，血清 E-Cadherin 水平低［（12.54±3.28）ng/mL vs（16.57±4.29）ng/mL，t= 6.328， P< 0.001］。多因素logistic回归分析结果显示，高HbA1C、高UAER、高βTP和低E-Cadherin水平为DKD的独立危险因素（P＜0.05）。ROC结果显示，血清βTP联合E-Cadherin预测DKD的曲线下面积（AUC）为0.904（灵敏度为0.847，特异度为0.807），优于两者单独诊断。结论 血清βTP、E-Cadherin水平异常是DKD发生的独立危险因素，且二者联合检测对DKD的早期诊断效能较高。
中文关键词: 糖尿病肾病 糖尿病 β-痕迹蛋白 E-钙黏蛋白 尿白蛋白/尿肌酐比值
Abstract:Objective To explore the level of serum β-trace protein (βTP) and E-Cadherin in patients with diabetic kidney disease (DKD), and to evaluate the value of both alone and in combination for the early diagnosis of DKD. Methods A total of 150 patients with DKD treated in the Third Hospital of Changsha from January 2024 to August 2024 were prospectively selected (DKD group), and 150 patients with simple diabetes mellitus (DM) were selected according to the ratio of 1∶1 during the same period (DM group). According to urinary albumin-to-creatinine ratio (UACR), the patients in DKD group were further divided into early group (30 mg/g≤UACR<300 mg/g, n=84) and clinical group (UACR≥300 mg/g, n=66). The clinical data of the subjects were collected, and serum βTP and E- Cadherin levels were detected by enzyme - linked immunosorbent assay (ELISA). Multivariate logistic regression QR code for English version analysis was used to screen the independent risk factors of DKD. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of serum βTP and E-Cadherin levels alone and in combination for DKD. Results There were significant differences in systolic blood pressure (SBP), total cholesterol (TC), triglyceride (TG), glycosylated hemoglobin (HbA1C) and urinary albumin excretion rate (UAER) between DKD group and DM group (P＜ Compared with the DM group, the serum βTP level in the DKD group was higher [ ( 0.99±0.43) mg/L vs (0.57± 0.19) mg/L, t= 10.857, P＜0.01], and the serum E-Cadherin level was lower [ (14.80±4.36) ng/mL vs (23.60±7.30) ng/mL, t= 12.685, P＜0.001]. Compared with the early group, the serum βTP level in the clinical group was higher [ (1.24± 0.38) mg/L vs (0.79±0.36) mg/L, t= 7.333, P＜0.001], and the serum E-Cadherin level was lower [ (12.54±3.28) ng/mL vs (16.57±4.29) ng/mL, t= 6.328, P＜0.001]. Multivariate logistic regression analysis showed that high HbA1C, high UAER, high βTP and low E-Cadherin levels were independent risk factors for DKD (P＜0.05). ROC results showed that the area under curve (AUC) of serum βTP combined with E-Cadherin in predicting DKD was 0.904 (sensitivity was 0.847, and specificity was 0.807), which was better than the two diagnoses alone. Conclusion Abnormal levels of serum βTP and E-Cadherin are independent risk factors for the development of DKD, and the combined detection of βTP and E-Cadherin is effective for the early diagnosis of DKD.
keywords: Diabetic kidney disease Diabetes mellitus β-trace protein E-Cadherin Urinary albumin-to-creatinine ratio
文章编号： 中图分类号：R587 文献标志码：A
基金项目:湖南省自然科学基金项目（2024JJ9517）
附件
| 作者 | 单位 |
| 曾聪 | 湖南大学附属长沙医院长沙市第三医院肾病内科,湖南 长沙410015 |
| 向慧 | 湖南大学附属长沙医院长沙市第三医院肾病内科,湖南 长沙410015 |
| 邓薇 | 湖南大学附属长沙医院长沙市第三医院肾病内科,湖南 长沙410015 |
引用文本：
曾聪,向慧,邓薇.血清β-痕迹蛋白联合E-钙黏蛋白对糖尿病肾病的早期诊断价值[J].中国临床研究,2025,38(9):1350-1354.
曾聪,向慧,邓薇.血清β-痕迹蛋白联合E-钙黏蛋白对糖尿病肾病的早期诊断价值[J].中国临床研究,2025,38(9):1350-1354.