糖尿病肾病患者血清真核细胞翻译启始子2α、活化转录因子4水平与肾组织损伤、肾功能的相关性分析

毛财凤; 危娜敏; 汪太斌; 乔雨珊; 范瑞杰; 李泽发

doi:10.7619/jcmp.20233794

糖尿病肾病患者血清真核细胞翻译启始子2α、活化转录因子4水平与肾组织损伤、肾功能的相关性分析

Correlations of serum eukaryotic translation promoter 2α and activated transcription factor 4 levels with renal tissue injury and renal function in diabetic nephropathy patients

摘要

摘要:
目的探讨糖尿病肾病(DN)患者血清真核细胞翻译启始子2α(eIF2α)、活化转录因子4(ATF4)水平与肾组织损伤程度和肾功能的相关性。
方法选择102例DN患者(DN组)和102例单纯糖尿病患者(对照组)为研究对象, 根据肾组织损伤严重程度将DN患者分为微量白蛋白尿期组(MG组, 35例)、显性蛋白尿期组(PG组, 41例)和肾功能不全期组(RIG组, 26例)。检测血清eIF2α、ATF4、尿素氮(BUN)、血肌酐(Scr)、胱抑素C(CysC)、估算的肾小球滤过率(eGFR)水平。采用Pearson相关性分析探讨eIF2α、ATF4与BUN、Scr、CysC、eGFR的相关性，采用多因素Logistic回归分析探讨DN发病的危险因素，采用受试者工作特征(ROC)曲线分析eIF2α和ATF4诊断DN的价值。
结果 DN组血清eIF2α、ATF4、BUN、Scr、CysC水平高于对照组, eGFR低于对照组，差异有统计学意义(P＜0.05)。RIG组血清eIF2α和ATF4水平高于PG组和MG组，差异有统计学意义(P＜0.05)。DN患者血清eIF2α、ATF4水平与BUN、Scr、CysC呈正相关，与eGFR呈负相关(P＜0.05)。较长糖尿病病程、较高体质量指数、高水平eIF2α、高水平ATF4是DN的危险因素(P＜0.05)。eIF2α、ATF4诊断DN的曲线下面积分别为0.770、0.799, 联合诊断曲线下面积为0.879, 大于单独诊断(P＜0.05)。
结论 DN患者血清eIF2α、ATF4水平增高，且与DN肾损伤程度加重以及肾功能减退有关, eIF2α联合ATF4在DN诊断中有较高价值。

Abstract:
Objective To investigate the correlations of serum eukaryotic translation promoter 2α (eIF2α) and activated transcription factor 4 (ATF4) levels with the degree of renal tissue injury and renal function in patients with diabetic nephropathy (DN).
Methods A total of 102 patients with DN (DN group) and 102 patients with simple diabetes (control group) were selected. According to the severe degree of renal tissue damage, the patients with DN were divided into microalbuminuria group (MG group, 35 cases) and dominant albuminuria group (PG group, 41 cases) and renal dysfunction group (RIG group, 26 cases). Serum levels of eIF2α, ATF4, urea nitrogen (BUN), creatinine (Scr), cystatin C (CysC) and estimated glomerular filtration rate (eGFR) were measured. Pearson correlation analysis was used to explore the correlations of eIF2α and ATF4 with BUN, Scr, CysC and eGFR; multivariate Logistic regression analysis was used to explore the risk factors of DN; receiver operating characteristic (ROC) curve was used to analyze the value of eIF2α and ATF4 in diagnostic of DN.
Results Serum levels of eIF2α, ATF4, BUN, Scr and CysC in the DN group were higher than those in control group, eGFR was lower than that in control group (P < 0.05). Serum eIF2α and ATF4levels in the RIG group were higher than those in PG and MG groups (P < 0.05). Serum eIF2α and ATF4 levels in DN patients were positively correlated with BUN, Scr and CysC, and negatively correlated with eGFR (P < 0.05). Long duration of diabetes, higher body mass index, high level of eIF2α and high level of ATF4 were risk factors for DN (P < 0.05). The area under the curve of eIF2α and ATF4 in diagnosis DN was 0.770 and 0.799, respectively, and the area under the curve of their combined diagnosis was 0.879, which was higher than that of single diagnosis (P < 0.05).
Conclusion Serum levels of eIF2α and ATF4 are increased in patients with DN, which is related to the severity of renal injury and renal dysfunction in DN. The combination of eIF2α and ATF4 is of high value in the diagnosis of DN.

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