检验医学 ›› 2025, Vol. 40 ›› Issue (7): 648-653.DOI: 10.3969/j.issn.1673-8640.2025.07.003

• 论著 • 上一篇    下一篇

糖尿病肾病患者血清Cat S、β2-MG、suPAR与病情严重程度的相关性

徐娜1, 宋永华1, 张杰南2, 聂婵娟1()   

  1. 1.石家庄市妇幼保健院检验科,河北 石家庄 050093
    2.石家庄市人民医院肾内科,河北 石家庄 050030
  • 收稿日期:2024-06-05 修回日期:2025-02-02 出版日期:2025-07-30 发布日期:2025-07-28
  • 通讯作者: 聂婵娟,E-mail:87925970@qq.com
  • 作者简介:聂婵娟,E-mail:87925970@qq.com
    徐娜,女,1985年生,学士,主管检验师,主要从事临床生化检验工作。
  • 基金资助:
    河北省卫生健康委员会医学科学研究课题(20241958)

Correlation between serum Cat S,β2-MG,suPAR and severity of diabetic nephropathy

XU Na1, SONG Yonghua1, ZHANG Jienan2, NIE Chanjuan1()   

  1. 1. Department of Clinical Laboratory,Shijiazhuang Maternal and Child Health Hospital,Shijiazhuang 050093,Hebei,China
    2. Department of Nephrology,Shijiazhuang People's Hospital,Shijiazhuang 050030,Hebei,China
  • Received:2024-06-05 Revised:2025-02-02 Online:2025-07-30 Published:2025-07-28

摘要:

目的 探讨糖尿病肾病(DN)患者血清组织蛋白酶S(Cat S)、β2-微球蛋白(β2-MG)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)与病情严重程度的相关性。方法 选取2020年11月—2023年11月石家庄市妇幼保健院DN患者140例(DN组)、单纯2型糖尿病(T2DM)患者162例(T2DM组)和健康体检者140名(正常对照组)。收集所有研究对象的临床资料和相关实验室检测结果。根据间质性纤维化和肾小管萎缩(IFTA)评分将DN患者分为轻度组(43例,IFTA评分为0分)、中度组(35例,IFTA评分为1分)、微重度组(31例,IFTA评分为2分)、重度组(31例,IFTA评分为3分)。采用Logistic回归分析评估重度DN的影响因素。采用Spearman相关分析评估各项指标与DN患者病情严重程度的相关性。采用受试者工作特征(ROC)曲线评价各项指标诊断DN的效能。结果 DN组、T2DM组、正常对照组血清Cat S、β2-MG、suPAR水平均依次降低(P<0.001)。3个组各项临床资料差异均无统计学意义(P>0.05)。轻度组、中度组、微重度组、重度组病程和糖化血红蛋白(HbAlc)、Cat S、β2-MG、suPAR依次升高(P<0.001),重度组高血压患者例数多于轻度组、中度组和微重度组(P<0.05)。4组之间其他指标差异均无统计学意义(P>0.05)。血清Cat S、β2-MG、suPAR、HbAlc水平和T2DM病程、高血压与DN病情严重程度均呈正相关(r值分别为0.656、0.782、0.849、0.751、0.705、0.817,P<0.001)。病程长、合并高血压和HbAlc、Cat S、β2-MG、suPAR水平升高均是重度DN的危险因素(P<0.05)。血清Cat S、β2-MG、suPAR单项检测和联合检测诊断重度DN的曲线下面积(AUC)分别为0.815、0.851、0.878、0.979。结论 DN患者血清Cat S、β2-MG、suPAR水平与其病情严重程度密切相关,可作为DN病情的判断指标。

关键词: 组织蛋白酶S, β2-微球蛋白, 可溶性尿激酶型纤溶酶原激活物受体, 糖尿病肾病

Abstract:

Objective To investigate the correlation between serum cathepsin S(Cat S),beta 2-microglobulin(β2-MG),soluble urokinase-type plasminogen activator receptor(suPAR) and the severity of diabetic nephropathy(DN). Methods A total of 140 patients with DN(DN group),162 patients with simple type 2 diabetes mellitus(T2DM)(T2DM group)and 140 healthy subjects(healthy control group)in Shijiazhuang Maternal and Child Health Hospital from November 2020 to November 2023 were enrolled. The clinical data and laboratory determination results were collected. According to the scores of interstitial fibrosis and tubular atrophy(IFTA),DN patients were classified into mild group(43 cases,with an IFTA score of 0),moderate group(35 cases,with an IFTA score of 1),slightly severe group(31 cases,with an IFTA score of 2)and severe group(31 cases,with an IFTA score of 3). Logistic regression analysis was used to evaluate the influencing factors of severe DN incidence,and Spearman correlation analysis was applied to analyze the correlation between each index and the severity of DN. The efficacy of each index in diagnosing DN was evaluated by receiver operating characteristic(ROC)curve. Results The serum levels of Cat S,β2-MG and suPAR in DN group,T2DM group and healthy control group were decreased sequentially(P<0.001). There was no statistical significance in various clinical data among the 3 groups(P>0.05). Course of T2DM disease and the serum levels of glycated hemoglobin A1c(HbA1c),Cat S,β2-MG and suPAR in mild group,moderate group,slightly severe group and severe group were all increased sequentially(P<0.001). The number of hypertension patients in severe group was higher than those in mild group,moderate group and slightly severe group(P<0.05). There was no statistical significance in the other indicators among the 3 groups(P>0.05). The levels of serum Cat S,β2-MG,suPAR,HbA1c,disease course and hypertension were all positively correlated with the severity of DN(r=0.656,0.782,0.849,0.751,0.705 and 0.817,P<0.001). Course of T2DM disease,hypertension and elevated HbA1c,serum Cat S,β2-MG and suPAR levels were risk factors for severe DN(P<0.05). The areas under curves(AUC)of serum Cat S,β2-MG and suPAR single and combined determinations for the diagnosis of severe DN were 0.815,0.851,0.878 and 0.979,respectively. Conclusions The serum levels of Cat S,β2-MG and suPAR in DN patients are positively correlated with DN severity,which can be used as indicators for judging the condition of DN.

Key words: Cathepsin S, Beta 2-microglobulin, Soluble urokinase-type plasminogen activator receptor, Diabetic nephropathy

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