糖尿病肾病患者血清分泌型卷曲相关蛋白-4、脂氧素A4、趋化素的表达及意义

金倩倩; 李华君; 王晓蕴; 王元松; 董艳芳; 孔五宝; 孙云川; 赵红敏; 牛跃龙

doi:10.7619/jcmp.20221844

糖尿病肾病患者血清分泌型卷曲相关蛋白-4、脂氧素A4、趋化素的表达及意义

Expression of significance of serum secreted frizzled-related protein-4, lipoxygenase A4 and chemerin in patients with diabetic nephropathy

摘要

摘要:
目的探讨糖尿病肾病（DN）患者血清分泌型卷曲相关蛋白-4（SFRP-4）、脂氧素A4、趋化素的表达及其与氧化应激、肾功能的相关性。
方法回顾性选取2019年2月—2021年6月收治的120例2型糖尿病患者纳入观察组，并选取同期122例健康体检者纳入对照组。根据是否合并肾病，将观察组患者进一步分为合并组56例和未合并组64例。比较各组SFRP-4、趋化素、脂氧素A4水平和肾功能指标尿素氮（BUN）、尿酸（UA）、氧化应激指标丙二醛（MDA）、超氧化物歧化酶（SOD）水平，采用受试者工作特征（ROC）曲线分析各项指标对DN的诊断效能，采用Pearson相关分析法分析脂氧素A4、趋化素、SFRP-4与肾功能指标、氧化应激指标的相关性。
结果观察组SFRP-4、趋化素、MDA、BUN、UA水平高于对照组，脂氧素A4、SOD水平低于对照组，差异有统计学意义（P < 0.05）；合并组SFRP-4、趋化素、MDA、BUN、UA水平高于未合并组，脂氧素A4、SOD水平低于未合并组，差异有统计学意义（P < 0.05）。ROC曲线显示，SFRP-4、脂氧素A4、趋化素、MDA、SOD、BUN、UA诊断DN的曲线下面积（AUC）分别为0.783、0.753、0.844、0.722、0.851、0.760、0.871。相关性分析结果显示，SFRP-4与MDA、BUN、UA均呈正相关（r=0.612、0.620、0.629，P < 0.001），与SOD无相关性（r=0.058，P=0.526）；脂氧素A4与SOD呈正相关（r=0.712，P < 0.001），与MDA、BUN均呈负相关（r=-0.316，P < 0.001；r=-0.233，P=0.010），与UA无相关性（r=0.119，P=0.197）；趋化素与MDA、BUN、UA均呈正相关（r=0.586、0.688、0.669，P < 0.001），与SOD无相关性（r=-0.031，P=0.739）。
结论趋化素、SFRP-4、脂氧素A4在DN患者中的表达水平与肾功能、氧化应激反应具有一定关联，或可作为诊断DN的新标志物。

Abstract:
Objective To explore the expressions of serum secreted frizzled-related protein-4 (SFRP-4), lipoxin A4 and chemerin in patients with diabetic nephropathy and their correlations with oxidative stress and renal function.
Methods A total of 120 patients with type 2 diabetes admitted from February 2019 to June 2021 were retrospectively selected as observation group, and 122 healthy subjects during the same period were selected as control group. Patients in the observation group were divided into combined group (n=56) and non-combined group (n=64) according to the presence or absence of nephropathy. The levels of SFRP-4, chemerin, lipoxine A4, renal functionindicatorsurea nitrogen (BUN), uric acid (UA), oxidative stress indicatorsmalondialdehyde (MDA), superoxide dismutase (SOD)were compared among different groups.Receiver operating characteristic (ROC) curve was used to analyze the efficacy of each index in diagnosis of DN. Pearson correlation analysis was used to analyze the correlations of lipoxane A4, chemokine, SFRP-4 with renal function indexes and oxidative stress indexes.
Results The levels of SFRP-4, chemerin, MDA, BUN and UA in the observation group were higher than those in the control group, while the levels of lipoxin A4 and SOD in the observation group were lower than those in the control group (P < 0.05); the levels of SFRP-4, chemerin, MDA, BUN and UA in the combined group were higher than those in the non-combined group, while the levels of lipoxin A4 and SOD in the combined group were lower than those in the non-combined group (P < 0.05). ROC curve showed that the area under curves (AUC) of SFRP-4, lipoxin A4, chemokine, MDA, SOD, BUN, UA in diagnosing DN were 0.783, 0.753, 0.844, 0.722, 0.851, 0.760, 0.871, respectively. The results of correlation analysis showed that SFRP-4 was positively correlated with MDA, BUN, UA (r=0.612, 0.620, 0.629, P < 0.001), but showed no correlation with SOD (r=0.058, P=0.526). Lipoxin A4 was positively correlated with SOD (r=0.712, P < 0.001), negatively correlated with MDA and BUN (r=-0.316, P < 0.001; r=-0.233, P=0.010), and had no correlation with UA (r=0.119, P=0.197). Chemerin was positively correlated with MDA, BUN, UA (r=0.586, 0.688, 0.669, P < 0.001), but had no correlation with SOD (r=-0.031, P=0.739).
Conclusion The expression levels of chemerin, SFRP-4 and lipoxin A4 in DN patients are related to renal function and oxidative stress response, and can be used as new markers for the diagnosis of DN.

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