目的 探讨血清中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipoca-lin,NGAL)联合甘油三酯/胱抑素C(triglyceride/cystatin C,TG/Cys-C)在糖尿病肾病早期诊断中的价值.方法 选取2022 年7 月～2023 年7 月本医院收治的88 例早期糖尿病肾病患者为观察组,另选取同期收治的单纯糖尿病患者85 例为参照组.收集 2 组患者基本资料,分析影响早期糖尿病肾病的相关因素,参考受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)及曲线下面积(area under the curve,AUC)分析血清NGAL、TG/Cys-C诊断早期糖尿病肾病的价值.结果 2 组患者的性别、年龄、糖尿病病程、体质量指数(body mass index,BMI)、饮酒、吸烟、肾脏疾病史比较,差异无统计学意义(P＞0.05),观察组高血压史、高血脂史占比高于参照组(P＜0.05),观察组TG/Cys-C比值低于参照组(P＜0.05),观察组糖化血红蛋白(glycated hemoglobin,HbA1c)、空腹胰岛素、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDLC)、NGAL高于参照组(P＜0.05),多因素分析显示HbA1c、NGAL是早期糖尿病肾病的危险因素(P＜0.05),TG/Cys-C是早期糖尿病肾病的保护因素(P＜0.05).ROC曲线分析结果显示,血清NGAL、TG/Cys-C联合诊断糖尿病肾病的灵敏度为84.20%,特异度为 90.20%,AUC为 0.922,联合诊断特异度、AUC高于单独诊断(P＜0.05).结论 糖尿病肾病患者的血清NGAL、TG/Cys-C水平异常,血清NGAL联合TG/Cys-C早期诊断糖尿病肾病效能良好.
Value analysis of serum NGAL combined with TG/Cys-C in early diagnosis of diabetic nephropathy
Objective To investigate the value of serum neutrophil gelatinase-associated li-pocalin(NGAL)combined with triglyceride/cystatin C(TG/Cys-C)in the early diagnosis of di-abetic nephropathy.Methods A total of 88 patients with early diabetic nephropathy admitted to our hospital from July 2022 to July 2023 were selected as the observation group,and 85 pa-tients with simple diabetes admitted to the hospital during the same period were selected as the reference group.Basic data of 2 groups of patients were collected to analyze the related factors affecting early diabetic nephropathy,and the value of serum NGAL and TG/Cys-C in the diag-nosis of early diabetic nephropathy was analyzed by reference to receiver operating characteristic(ROC)curve and area under the curve(AUC).Results There was no significant difference in gender,age,diabetes course,body mass index(BMI),drinking,smoking and history of kidney disease between 2 groups(P＞0.05).The proportion of hypertension and hyperlipi-demia in observation group was higher than that in reference group(P＜0.05),and the ratio of TG/Cys-C in observation group was lower than that in reference group(P＜0.05).Glycated hemoglobin(HbA1c),fasting insulin,triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDLC)and NGAL in observation group were higher than those in refer-ence group(P＜0.05).Multivariate analysis showed that HbA1c and NGAL were risk factors for early diabetic nephropathy(P＜0.05),and TG/Cys-C were protective factors for early dia-betic nephropathy(P＜0.05).ROC curve analysis showed that the sensitivity,specificity and AUC of serum NGAL and TG/Cys-C in the diagnosis of diabetic nephropathy were 84.20%,90.20%and 0.922,respectively,and the specificity and AUC of combined diagnosis were higher than those of single diagnosis(P＜0.05).Conclusion The levels of serum NGAL and TG/Cys-C in diabetic nephropathy patients are abnormal,and serum NGAL combined with TG/Cys-C is effective in early diagnosis of diabetic nephropathy.
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