尿液肝型脂肪酸结合蛋白对早期糖尿病肾病的诊断价值.docxVIP

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尿液肝型脂肪酸结合蛋白对早期糖尿病肾病的诊断价值

【摘要】目的：探讨尿液肝型脂肪酸结合蛋白（L-FABP）对早期糖尿病肾病（DKD）的诊断价值。方法：选取2022年1月至2023年12月就诊的2型糖尿病患者66例，根据尿白蛋白/肌酐比值（UACR）分为早期DKD组（UACR30-300mg/g）和糖尿病无肾病组（UACR30mg/g），另选33名健康志愿者作为对照组。检测所有研究对象尿L-FABP水平，分析其与UACR、估算肾小球滤过率（eGFR）的相关性，绘制受试者工作特征（ROC）曲线评估诊断效能。结果：早期DKD组尿L-FABP水平显著高于糖尿病无肾病组和健康对照组（P0.01）。尿L-FABP与UACR呈正相关（r=0.72，P0.01），与eGFR呈负相关（r=-0.68，P0.01）。ROC曲线分析显示，尿L-FABP诊断早期DKD的曲线下面积（AUC）为0.91（95%CI：0.85-0.97），最佳截断值为12.5μg/g，敏感性和特异性分别为88.6%和85.3%。结论：尿L-FABP是诊断早期DKD的敏感性和特异性较高的生物标志物，具有重要的临床应用价值。

【关键词】糖尿病肾病；肝型脂肪酸结合蛋白；早期诊断；生物标志物

Abstract:Objective:Toexplorethediagnosticvalueofurineliver-typefattyacidbindingprotein(L-FABP)forearlydiabetickidneydisease(DKD).Methods:Sixty-sixpatientswithtype2diabeteswhovisitedthehospitalfromJanuary2022toDecember2023wereselected.TheyweredividedintotheearlyDKDgroup(UACR30-300mg/g)andthediabeteswithoutkidneydiseasegroup(UACR30mg/g)basedontheurinealbumin/creatinineratio(UACR).Another33healthyvolunteerswereselectedasthecontrolgroup.TheurineL-FABPlevelsofallstudysubjectsweredetected,andthecorrelationwithUACRandestimatedglomerularfiltrationrate(eGFR)wasanalyzed.Thereceiveroperatingcharacteristic(ROC)curvewasdrawntoevaluatethediagnosticefficacy.Results:TheurineL-FABPlevelintheearlyDKDgroupwassignificantlyhigherthanthatinthediabeteswithoutkidneydiseasegroupandthehealthycontrolgroup(P0.01).UrineL-FABPwaspositivelycorrelatedwithUACR(r=0.72,P0.01),andnegativelycorrelatedwitheGFR(r=-0.68,P0.01).TheareaundertheROCcurve(AUC)fordiagnosingearlyDKDbyurineL-FABPwas0.91(95%CI:0.85-0.97),withtheoptimalcut-offvalueof12.5μg/g,andthesensitivityandspecificitywere88.6%and85.3%,respectively.Conclusion:UrineL-FABPisasensitiveandspecificbiomarkerforthediagnosisofearlyDKD,withimportantclinicalapplicationvalue.

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