尿中性粒细胞明胶酶相关脂质运载蛋白在糖尿病肾病早期诊断中的作用

摘要

目的：探讨尿中性粒细胞明胶酶脂质运载蛋白（ NGAL）检测在糖尿病肾病（ DN）诊断中的价值。方法收集糖尿病患者120例，根据24 h尿白蛋白排泄率（ UAER）分为正常白蛋白尿（ NA）组46例、微量蛋白尿（ MA）组39例和临床肾病（ CA）组35例；同期随机选取健康体检者50名作为正常对照（ NC）组。应用酶联免疫吸附试验（ELISA）检测血清NGAL浓度，同时用碱性苦味酸法检测血清肌酐（SCr）浓度，用胶乳增强免疫浊度法检测血清半胱氨酸蛋白酶抑制剂C（ Cys C）浓度，并进行比对分析。结果 NA组尿NGAL水平明显高于NC组（P＜0．05），而血清Cys C、SCr浓度2组之间差异无统计学意义（P＞0．05）。 MA组尿NGAL、血清Cys C水平明显高于NC组（P＜0．05），SCr浓度2组之间差异无统计学意义（P＞0．05）。 CA组尿NGAL、血清Cys C、SCr水平均明显高于NC组（ P＜0．05）。结论尿NGAL是反映糖尿病早期肾损伤的良好指标。%Objective To investigate the significance of urinary neutrophil gelatinase-associated lipocalin ( NGAL) in the diagnosis of diabetic nephropathy ( DN) .Methods A total of 120 diabetes mellitus patients were enrolled in the study.According to 24 h urine albumin excretion rate ( UAER), the patients were classified into 3 groups, normal albuminuria (NA, 46 cases), microalbuminuria (MA, 39 cases) and clinical albuminuria (CA, 35 cases) groups. Another 50 healthy subjects were enrolled as normal control ( NC) group.Serum NGAL concentrations were determined by enzyme-linked immunosorbent assay ( ELISA) .Serum creatinine ( SCr) levels were determined by Jaff éreaction-rate method.Serum cystatin C (Cys C) concentrations were determined by latex-enhanced immune turbidity method .The results were analyzed comparatively .Results Urine NGAL concentration in NA group was significantly higher than that in NC group(P<0.05).No statistical significance was observed in concentrations of serum Cys C and SCr between NA and NC groups (P>0.05).Urinary NGAL and serum Cys C levels in MA group were significantly higher than those in NC grpup (P<0.05).No statistical significance of SCr was found between MA and NC groups (P>0.05).Urinary NGAL, serum Cys C and SCr levels in CA group were all significantly higher than those in NC group (P <0.05). Conclusions Urinary NGAL may be a biomarker for early renal damage in diabetes mellitus .