Study on the Relationship Between Glomerular Filtration Rate and Serum Levels of VEGF and Bilirubin in Diabetic Kidney Disease
LIAO Tao-sheng;FENG Tao;LIU Bin-xian;JING Chun-lan;Department of Internal Three Medicine,Ganzi Tibetan Autonomous Prefecture People's Hospital;Department of Nephrology ,The Second Affiliated Hospital of Baotou Medical College;Department of Nephrology ,People's Hospital of Cangxi;Department of Endocrinology ,People's Hospital of Ziyang;
Objective To study the relationship between glomerular filtration rate( eGFR),serum levels of vascular endothelial growth factor( VEGF) and bilirubin in diabetic kidney disease( DKD). Methods 90 cases of patients with DKD treated in our hospital from January 2016 to February 2017 were selected as the study subjects( DKD group). According to the eGFR level,they were divided into A1 groups [eGFR level 60 m L/[min ·( 1. 73 m~2) ]],A2 group [60 m L/[min ·( 1. 73 m~2) ]≤ eGFR level 90 m L/[min ·( 1. 73 m~2) ]]and A3 group [eGFR level ≥ 90 m L/[min·( 1. 73 m~2) ]]. Another 50 cases with simple diabetes mellitus( DM) and 50 healthy volunteers were included into the DMgroup and the healthy group,respectively. The eGFR,serum albumin( ALB),uric acid( UA),total bilirubin( TBIL),direct bilirubin( DBIL),VEGF,total cholesterol( TC) and triglyceride( TG) levels were compared among DKD group,DMgroup and healthy group. The course of disease and the above indicators were compared among A1 group,A2 group and A3 group. The relationship between eGFR and other biochemical indicators was analyzed,the efficiencies of eGFR,VEGF and TBIL in the diagnosis of DKD were evaluated,and the independent risk factors influencing eGFR in patients with DKD were also analyzed. Results The serum levels of eGFR,ALB,TBIL and DBIL in the DKD group [( 70. 18 ± 20. 56) m L/[min ·( 1. 73 m2) ],( 35. 29 ± 10. 67) g/L,( 9. 18 ± 2. 65) μmol/L and( 2. 17 ± 0. 45) μmol/L]were lower than those in DMgroup and healthy group,while levels of UA,SCr,VEGF,TC and TG [( 401. 23 ± 10. 09) μmol/L,( 1. 29 ± 0. 67) mg/d L,( 55. 29 ±1. 25) pg/m L,( 6. 30 ± 2. 12) mmol/L and( 2. 79 ± 1. 36) mmol/L] were significantly higher than those in DMgroup and healthy group( P 0. 05). The course of disease in A1 group was longer than that in A2 group and A3 group. Levels of serum ALB,SCr,TBIL and DBIL were lower in A1 group than A2 group and A3 group,while levels of UA,VEGF,TC and TG were higher than A2 group and A3 group( P 0. 05).Correlation analysis showed that eGFR was positively correlated with TBIL and DBIL and negatively correlated with SCr,VEGF,TC and TG in patients with DKD( P 0. 05). The sensitivity,accuracy and specificity of combination of eGFR,VEGF and bilirubin in the diagnosis of DKD were higher than those of single index diagnosis. Logistic regression analysis showed that the course of disease,serum VGEGF,TG and TBIL were independent risk factors influencing eGFRin patients with DKD( P 0. 05). Conclusion The eGFR is highly related to serum VEGF and bilirubin levels in patients with DKD,which is helpful for clinical diagnosis.
【CateGory Index】： R587.2;R692.9