Objective To investigate the correlation between serum lipocalin 2(LCN-2),thrombospondin 2(TSP-2)levels and renal function and prognosis in patients with diabetes nephropathy(DN).Methods One hundred and fifty-five DN patients admitted to the Endocrinology Department of the First Affiliated Hospital of the Chinese People's Liberation Ar-my Air Force Medical University from January 2018 to December 2020 were selected as the DN group,70 simple T2DM pa-tients during the same period were selected as the simple T2DM group,and 70 healthy individuals during the same period were selected as the healthy control group.Based on the 3-year prognosis,DN patients were divided into 38 poor prognosis subgroups and 117 good prognosis subgroups.Serum LCN-2 and TSP-2 levels and renal function indicators were detected[estimated glomerular filtration rate(eGFR),urinary albumin creatinine ratio(UACR)];Pearson's method was used to analyze the correlation between serum LCN-2,TSP-2 levels and renal function indicators in DN patients;Logistic regression model was used to analyze the factors contributing to poor prognosis in DN patients;Receiver operating characteristic(ROC)curve was established to evaluate the predictive value of serum LCN-2 and TSP-2 levels for poor prognosis in DN patients.Results The serum levels of LCN-2,TSP-2,and UACR in the healthy control group,simple T2DM group,and DN group increased sequentially,while eGFR decreased sequentially(F/P=48.365/＜0.001,57.480/＜0.001,218.946/＜0.001,253.488/＜0.001);The 3 year incidence of poor prognosis in 155 DN patients was 24.52％(38/155);Compared with the subgroup with good prognosis,the subgroup with poor prognosis had higher LCN-2,TSP-2,UACR,and lower eGFR(t/P=7.057/＜0.001,6.457/＜0.001,4.967/＜0.001,5.398/＜0.001);The serum levels of LCN-2 and TSP-2 in DN patients were negatively correlated with eGFR(r/P=-0.745/＜0.001,-0.731/＜0.001),and positively correlated with UACR(r/P=0.703/＜0.001,0.691/＜0.001);Multivariate logistic regression showed that stage 4 chronic kidney disease,high glycated hemoglobin,high UACR,high LCN-2,and high TSP-2 were independent risk factors for poor prognosis in DN patients[OR(95％CI)=3.972(1.121-14.076),1.640(1.024-2.628),1.015(1.002-1.030),1.016(1.005-1.027),1.196(1.077-1.328)],and high eGFR was an inde-pendent protective factor[OR(95％6I)=0.959(0.924-0.994)];The area under the curve(AUC)of serum LCN-2,TSP-2 lev-els,and their combined prediction of adverse prognosis in DN patients were 0.795,0.783,and 0.882,respectively.The com-bined AUC of the two was greater than the AUC predicted solely by serum LCN-2 and TSP-2 levels(Z/P=3.200/0.001,2.680/0.007).Conclusion The elevated levels of serum LCN-2 and TSP-2 in DN patients are closely related to decreased re-nal function and prognosis.The combination of serum LCN-2 and TSP-2 levels has a high value in predicting the prognosis ofDN patients.
维普
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