Combined detection of serum NGAL and Cys C in the diagnosis of early nephropathy in patients with type 2 diabetes mellitus

doi:10.3969/j.issn.1673-8640.2021.03.010

Abstract

Abstract:

Objective To investigate the role of combined detection of neutrophil gelatinase-associated lipocalin（NGAL） and cystatin C（Cys C） in early renal injury in patients with type 2 diabetes mellitus（T2DM）. Methods A total of 95 T2DM patients were enrolled in the study. According to 24-hour urinary albumin excretion rate（UAER）,there were 29 patients with normal urinary albumin（NA group,UAER<30 mg/24 h）,33 patients with microalbuminuria（MA group,UAER：30-300 mg/24 h）and 33 patients with clinical albuminuria（CA group,UAER>300 mg/24 h）. Seventy-eight healthy subjects were collected into control group. The levels of serum urea,creatine,uric acid,NGAL,Cys C and urine α1-microglobulin were measured. The receiver operating characteristic（ROC）curve were applied for the evaluation of the diagnostic value of the indices. Results The levels of serum urea,creatine,uric acid,NGAL,Cys C and urine α1-microglobulin in MA and CA groups were significantly higher than those in the NA and control groups（P<0.05）. However,no significant difference was found in these indices between the NA and control group,or between the MA and CA group（P>0.05）. ROC curve showed that the area under curve（AUC）of serum urea,creatine,uric acid,NGAL,Cys C and urine α₁-microglobulin were 0.649,0.713,0.632,0.795,0.869 and 0.660,respectively. The joint detection of NGAL and Cys C had a higher AUC value（0.881） than the above-mentioned single index（P<0.000 1）. Conclusions The combined detection of NGAL and Cys C can facilitate the diagnosis for early renal injury in T2DM patients and serve as an ideal index of screening.

Key words: Neutrophil gelatinase-associated lipocalin, Cystatin C, Type 2 diabetes mellitus, Renal injury

CLC Number:

R446.1

ZHU Qinghua, WANG Weiwei, ZOU Guanghui, DONG Zhiwu. Combined detection of serum NGAL and Cys C in the diagnosis of early nephropathy in patients with type 2 diabetes mellitus[J]. Laboratory Medicine, 2021, 36(3): 281-284.

Figures/Tables 3

References 14

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组别	例数	尿素/（mmol/L）	Cr/（μmol/L）	UA/（μmol/L）
正常对照组	78	5.10（4.00~5.80）	59.00（53.75~69.00）	312.00（251.75~357.25）
NA组	29	4.00（3.20~4.85）	56.00（51.00~63.00）	298.00（218.50~355.50）
MA组	33	6.80（4.65~8.30）^*#	87.00（69.00~144.00）^*#	346.00（311.00~408.50）^*#
CA组	33	7.20（6.55~8.35）^*#	97.00（76.00~161.50）^*#	369.00（321.00~464.50）^*#
组别		α₁-MG/（mg/L）	NGAL/（ng/mL）	Cys C/（mg/L）
正常对照组		10.40（5.78~18.33）	55.85（46.43~69.10）	0.70（0.50~0.85）
NA组		7.70（5.78~10.90）	54.00（47.60~70.20）	0.82（0.74~0.91）
MA组		17.30（12.60~34.15）^*#	99.80（75.80~111.80）^*#	1.33（0.99~2.03）^*#
CA组		35.25（17.90~63.13）^*#	100.5（89.50~145.75）^*#	1.19（0.98~1.32）^*#

组别	例数	尿素/（mmol/L）	Cr/（μmol/L）	UA/（μmol/L）
正常对照组	78	5.10（4.00~5.80）	59.00（53.75~69.00）	312.00（251.75~357.25）
NA组	29	4.00（3.20~4.85）	56.00（51.00~63.00）	298.00（218.50~355.50）
MA组	33	6.80（4.65~8.30）^*#	87.00（69.00~144.00）^*#	346.00（311.00~408.50）^*#
CA组	33	7.20（6.55~8.35）^*#	97.00（76.00~161.50）^*#	369.00（321.00~464.50）^*#
组别		α₁-MG/（mg/L）	NGAL/（ng/mL）	Cys C/（mg/L）
正常对照组		10.40（5.78~18.33）	55.85（46.43~69.10）	0.70（0.50~0.85）
NA组		7.70（5.78~10.90）	54.00（47.60~70.20）	0.82（0.74~0.91）
MA组		17.30（12.60~34.15）^*#	99.80（75.80~111.80）^*#	1.33（0.99~2.03）^*#
CA组		35.25（17.90~63.13）^*#	100.5（89.50~145.75）^*#	1.19（0.98~1.32）^*#

指标	AUC（95%可信区间）	P值	最佳临界值	敏感性/%	特异性/%	约登指数
尿素	0.649（0.566 ~ 0.731）	0.001	6.05 mmol/L	52.1	84.6	0.367
Cr	0.713（0.636 ~ 0.789）	<0.001	71.5 μmol/L	52.1	87.2	0.393
UA	0.632（0.548 ~ 0.716）	0.003	299.5 μmol/L	78.7	48.7	0.274
NGAL	0.795（0.728 ~ 0.862）	<0.001	77.1 ng/mL	63.8	91.0	0.549
Cys C	0.869（0.818 ~ 0.921）	<0.001	0.89 mg/L	70.2	85.9	0.561
α₁-MG	0.660（0.580 ~ 0.740）	<0.001	25.6 mg/L	42.6	84.6	0.272
Cys C+NGAL	0.881（0.831 ~ 0.931）	<0.001	0.573	70.5	93.6	0.641

指标	AUC（95%可信区间）	P值	最佳临界值	敏感性/%	特异性/%	约登指数
尿素	0.649（0.566 ~ 0.731）	0.001	6.05 mmol/L	52.1	84.6	0.367
Cr	0.713（0.636 ~ 0.789）	<0.001	71.5 μmol/L	52.1	87.2	0.393
UA	0.632（0.548 ~ 0.716）	0.003	299.5 μmol/L	78.7	48.7	0.274
NGAL	0.795（0.728 ~ 0.862）	<0.001	77.1 ng/mL	63.8	91.0	0.549
Cys C	0.869（0.818 ~ 0.921）	<0.001	0.89 mg/L	70.2	85.9	0.561
α₁-MG	0.660（0.580 ~ 0.740）	<0.001	25.6 mg/L	42.6	84.6	0.272
Cys C+NGAL	0.881（0.831 ~ 0.931）	<0.001	0.573	70.5	93.6	0.641

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