The relationship between serum LRG1 level and urinary albumin-to-creatinine ratio in patients with type 2 diabetes

doi:10.12114/j.issn.1007-9572.2020.00.289

Abstract

Abstract: Background　The threat of diabetic kidney disease to human health has always been a concern of medical workers.However，the clinical diagnosis of diabetic kidney disease is still relatively limited currently.Leucine-rich-alpha-2-glycoprotein-1（LRG1） may become an accurate，simple and less risky biomarker for early detection of diabetic kidney disease，but there are few relevant research in China.Objective　To investigate the relationship between serum LRG1 level and urinary albumin-to-creatinine ratio（ACR） in patients with type 2 diabetes，in order to explore the role of LRG1 in the pathogenesis of diabetic kidney disease.Methods　A total of 290 patients with type 2 diabetes were enrolled in this study and divided into three groups according to the different ACR，normal albuminuria group（group D1），microalbuminuria group（group D2），and macroalbuminuria group（group D3）.And 128 healthy volunteers matched the experimental group for the level of age and gender were selected as the control group（group N）.The clinical data of the research subjects were collected，and serum LRG1 level，inflammatory markers，and fibrosis markers were detected for statistical analysis.Results　The difference of LRG1 levels between groups was statistically significant（P<0.001）.The serum LRG1 level in group D3 was higher than that in group D2，group D1 and group N；the serum LRG1 level in group D2 was higher than that in group D1 and group N；the serum LRG1 level in group D1 was higher than that in group N（P<0.05）.Correlation analysis showed that the serum LRG1 level was positively correlated with FPG（r=0.578），HOMA-IR（r=0.632），CRP（r=0.834），LRG1（r=0.930），TGF-β1（r=0.739），FN（r=0.920），and VEGF（r=0.691），while it was negatively correlated with HDL-C（r=-0.328）（P<0.01）.Conclusion　The serum LRG1 level in patients with type 2 diabetes may become a new biological marker for early detection of diabetic kidney disease，and it is related to the inflammation，fibrosis and abnormal angiogenesis of kidney injury caused by type 2 diabetes.

Key words: Diabetes mellitus, type 2 ；Diabetic nephropathies；Leucine-rich-alpha-2-glycoprotein-1；Urinary albumin excretion rate；Urinary albumin-to-creatinine ratio

摘要： 背景　糖尿病肾病对人类健康的威胁是医疗工作者始终关注的问题，目前临床诊断糖尿病肾病方法较单一，富亮氨酸α-2糖蛋白-1（LRG1）可能成为早期发现糖尿病肾病且准确、简便及风险性更小的生物学标志物，而国内相关的研究较少。目的　研究2型糖尿病患者血清LRG1水平及与尿微量白蛋白/肌酐（ACR）的关系，探讨LRG1在糖尿病肾病发病机制中的作用。方法　本研究共纳入2型糖尿病患者290例，根据不同ACR分为正常白蛋白尿组（D1组）、微量白蛋白尿组（D2组）和大量白蛋白尿组（D3组），选取同期年龄、性别与实验组相匹配的健康志愿者128例作为对照组（N组）。收集研究对象的临床资料，检测血清中LRG1、炎性指标、纤维化指标等，进行统计分析。结果　各组间LRG1 比较，差异有统计学意义（P<0.001），其中D3组LRG1要高于D2、D1和N组，D2组高于D1和N组，D1组高于N组，差异均有统计学意义（P<0.05）。相关性分析显示：血清logACR与空腹血糖（r=0.578）、胰岛素抵抗指数（r=0.632）、C反应蛋白（r=0.834）、LRG1（r=0.930）、转化生长因子-β1（r=0.739）、纤维连接蛋白（r=0.920）、血管内皮生长因子（r=0.691）呈线性正相关，而与高密度脂蛋白胆固醇（r=-0.328）呈线性负相关（P<0.01）。结论　2型糖尿病患者LRG1水平可能成为早期预测糖尿病肾病的新型血清标志物，与2型糖尿病肾脏损伤的炎性反应、纤维化过程及异常血管新生过程有关。

关键词: 糖尿病, 2型, 糖尿病肾病, 富亮氨酸α-2糖蛋白-1, 尿白蛋白排泄率, 尿微量白蛋白/肌酐

ZHANG Jun,YU Jing,HAN Yanqiu, et al. The relationship between serum LRG1 level and urinary albumin-to-creatinine ratio in patients with type 2 diabetes[J]. Chinese General Practice, 2020, 23(19): 2446-2450. DOI: 10.12114/j.issn.1007-9572.2020.00.289.
张俊,于菁,韩艳秋等. 2型糖尿病患者血清LRG1与尿微量白蛋白/肌酐的关系研究[J]. 中国全科医学, 2020, 23(19): 2446-2450. DOI: 10.12114/j.issn.1007-9572.2020.00.289.

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