■几种尿生物标志物对糖尿病肾病(DKD)有很好的诊断价值;然而,使用单一生物标志物的预测价值有限.我们研究了Luminex液体悬浮芯片同时检测几种尿液生物标志物的临床价值。
■该研究包括737名患者:585名患有糖尿病(DM)的患者和152名患有DKD的患者。人口统计学和医学特征的倾向得分匹配(PSM)确定了78名患者的子集(DM=39,DKD=39)。使用两种Luminex液体悬浮芯片根据其分子量和浓度检测11种尿液生物标志物。生物标志物,包括胱抑素C(CysC),nephrin,表皮生长因子(EGF),肾损伤分子-1(KIM-1),视黄醇结合蛋白4(RBP4),α1-微球蛋白(α1-MG),β2-微球蛋白(β2-MG),维生素D结合蛋白(VDBP),金属蛋白酶组织抑制剂-1(TIMP-1),肿瘤坏死因子受体-1(TNFR-1),比较DM组和DKD组的肿瘤坏死因子受体2(TNFR-2)。使用受试者工作特征(ROC)曲线分析评估了单个生物标志物和各种生物标志物组合对DKD早期诊断的诊断价值。
■尿中VDBP水平,DKD组的RBP4和KIM-1明显高于DM组(p<0.05),而TIMP-1、TNFR-1、TNFR-2、α1-MG、β2-MG,CysC,nephrin,和EGF水平在各组之间没有显着差异。RBP4、KIM-1、TNFR-2和VDBP在单变量分析中达到p<0.01,并进入最终分析。VDBP的AUC最高(0.780,p<0.01),其次是RBP4(0.711,p<0.01),KIM-1(0.640,p=0.044),和TNFR-2(0.615,p=0.081)。然而,这四种尿生物标志物的组合具有最高的AUC(0.812),灵敏度为0.742,特异性为0.760。
■VDBP的尿水平,RBP4、KIM-1和TNFR-2可以使用Luminex液悬芯片技术同时检测。这些生物标志物的组合,反映了不同的肾脏损伤机制,对DKD的诊断价值最高。然而,这一发现应进一步探索,以了解这些生物标志物的协同作用.
UNASSIGNED: Several urinary biomarkers have good diagnostic value for diabetic kidney disease (DKD); however, the predictive value is limited with the use of single biomarkers. We investigated the clinical value of Luminex liquid suspension chip detection of several urinary biomarkers simultaneously.
UNASSIGNED: The study included 737 patients: 585 with diabetes mellitus (DM) and 152 with DKD. Propensity score matching (PSM) of demographic and medical characteristics identified a subset of 78 patients (DM = 39, DKD = 39). Two Luminex liquid suspension chips were used to detect 11 urinary biomarkers according to their molecular weight and concentration. The biomarkers, including cystatin C (CysC), nephrin, epidermal growth factor (EGF), kidney injury molecule-1 (KIM-1), retinol-binding protein4 (RBP4), α1-microglobulin (α1-MG), β2-microglobulin (β2-MG), vitamin D binding protein (VDBP), tissue inhibitor of metalloproteinases-1 (TIMP-1), tumor necrosis factor receptor-1 (TNFR-1), and tumor necrosis factor receptor-2 (TNFR-2) were compared in the DM and DKD groups. The diagnostic values of single biomarkers and various biomarker combinations for early diagnosis of DKD were assessed using receiver operating characteristic (ROC) curve analysis.
UNASSIGNED: Urinary levels of VDBP, RBP4, and KIM-1 were markedly higher in the DKD group than in the DM group (p < 0.05), whereas the TIMP-1, TNFR-1, TNFR-2, α1-MG, β2-MG, CysC, nephrin, and EGF levels were not significantly different between the groups. RBP4, KIM-1, TNFR-2, and VDBP reached p < 0.01 in univariate analysis and were entered into the final analysis. VDBP had the highest AUC (0.780, p < 0.01), followed by RBP4 (0.711, p < 0.01), KIM-1 (0.640, p = 0.044), and TNFR-2 (0.615, p = 0.081). However, a combination of these four urinary biomarkers had the highest AUC (0.812), with a sensitivity of 0.742 and a specificity of 0.760.
UNASSIGNED: The urinary levels of VDBP, RBP4, KIM-1, and TNFR-2 can be detected simultaneously using Luminex liquid suspension chip technology. The combination of these biomarkers, which reflect different mechanisms of kidney damage, had the highest diagnostic value for DKD. However, this finding should be explored further to understand the synergistic effects of these biomarkers.