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《Chinese Journal of Difficult and Complicated Cases》 2017-03
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The applications of urinary retinol binding protein,kidney injury molecule 1,serum cystatin in early diabetic nephropathy

KONG Yuan;XU Shuang;LI Ping;LIANG Linlang;Department of Endocrinology,General Hospital of Shenyang Military District;  
Objective To evaluate the diagnostic value of urine application and retinol binding protein(RBP),urinary kidney injury molecule 1(KIM-1) and serum cystalin C(Cys C) in diabetic nephropathy(DN).Methods One hundred and twenty-four patients with type 2 diabetes mellitus(DM) were randomly divided into normal albuminuria(NA,n =35),microalbuminuria(MA,n =45) and clinical white proteinuria group(CP,n =44) based on 24 h urinary albumin excretion rate(UAER).Another 35 healthy subjects were selected as the control group.All clinical data were recorded in each group and the levels of urine RBP,KIM-1 and blood Cys C were measured with ELISA.Results The levels of fasting plasma glucose(FPG),2h postprandial blood glucose(2 h PG),Fasting insulin(FINS),insulin resistance index(HOMA-IR),serum creatinine(SCr),blood urea nitrogen(BUN),RBP,KIM-1,Cys C of NA group,MA group,CP groups were significantly higher than control group(F =17.669,F =15.734,F =18.639,F =19.835,F =17.885,F =25.693,P =0.000).The levels of BMI,WC,FPG,2h PG,FINS,HOMA-IR,SCr,BUN,RBP,KIM-1,Cys C of MA group,CP group were higher than NA group(P 0.05).The levels of RBP,KIM-1,Cys C of MA group were higher than CP group(F =129.72,F =444.15,F =128.20,F =168.90,F =75.382,F =47.862,P =0.000).The area under the ROC curve of urinary RBP diagnosis of DN(AUC)was 0.712,95%CI 0.612 to 0.845);urinary KIM-1.diagnostic DN AUC of 0.672,95%CI 0.608 to0.782);blood Cys C diagnosis of DN AUC was 0.602,95%CI 0.526 to 0.712).Conclusion The levels of RBP,KIM-1 and Cys C in urine were closely related to the occurrence of early DN,which could be used as an early diagnostic index of DN.
【CateGory Index】: R587.2;R692.9
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