天津医药 ›› 2016, Vol. 44 ›› Issue (6): 752-754.doi: 10.11958/20150092

• 临床研究 • 上一篇    下一篇

HIF-1α、 VEGF 在预测早期糖尿病肾脏病中的价值

宋秋艳, 余玲, 董瑞鸿   

  1. 郑州大学第五附属医院内分泌科 (邮编450000)
  • 收稿日期:2015-08-05 修回日期:2015-11-02 出版日期:2016-06-15 发布日期:2016-07-04
  • 基金资助:
    河南省卫生厅资助项目 (201102007)

The predictive values of HIF-1 and VEGF in early diabetic nephropathy

SONG Qiuyan, YU Ling, DONG Ruihong   

  1. Department of Endocrinology, The Fifth Affiliated Hospital of Zhengzhou University, Henan 450000, China
  • Received:2015-08-05 Revised:2015-11-02 Published:2016-06-15 Online:2016-07-04

摘要: 摘要: 目的 通过分析缺氧诱导因子(HIF) -1α和血管内皮生长因子(VEGF)水平与肾小球滤过率(eGFR)的关系, 探讨 HIF-1α、 VEGF 在预测早期糖尿病肾脏病 (DKD) 中的价值。方法 76 例糖尿病肾脏病患者根据 eGFR 水平分为 DKD1 组 [eGFR>90 mL (min·1.73 m2), 48 例] 和 DKD2 组 [60 mL/ (min·1.73 m2) <eGFR≤90 mL/ (min·1.73 m2), 28 例], 另择同期健康体检者 23 例为对照组。采用液相免疫沉淀透射比浊法检测 24 h 尿微量白蛋白, 计算尿白蛋白排泄率(UAE); 酶联免疫吸附试验(ELISA)检测 HIF-1α、 VEGF。结果 DKD1 组、 DKD2 组 UAE、 HIF-1α、 VEGF 水平均明显高于对照组(均 P<0.05); DKD2 组 UAE 水平与 DKD1 组差异无统计学意义, HIF-1α、 VEGF 水平高于 DKD1 组 (均 P<0.05)。HIF-1α、 VEGF 与 eGFR 均呈负相关 (r 分别为-0.551、 -0.593, P < 0.05)。ROC 曲线显示, 血清 HIF-1α和 VEGF 的 ROC 曲线均位于机会对角线以上; HIF-1α对 DKD1 和 DKD2 诊断的敏感度分别为 92.1%、 87.4%, 特异度分别为 91.7%、 85.4%; VEGF 的敏感性分别为 96.1%、 86.2%, 特异度分别为 93.3%、 89.1%。结论 血清 HIF-1α和 VEGF 水平随糖尿病肾脏病进展的严重程度而发生变化, 有可能作为糖尿病肾脏病的早期预测指标。

关键词: 糖尿病肾病, 血管内皮生长因子类, 缺氧诱导因子 1, α亚基, 肾小球滤过率, 尿白蛋白排泄率

Abstract: Abstract:Objective To investigate the predictive values of hypoxia- induced factor(HIF)- 1α and vascular endothelial growth factor (VEGF) in patients with type 2 diabetic kidney disease, and its relationship between HIF- 1α, VEGF and glomerular filtration rate (eGFR). Methods Seventy- six patients with type 2 diabetic kidney disease were divided into two groups: DKD1 group [eGFR>90 mL/(min·1.73 m2), n=48] and DKD2 group [60 mL/(min·1.73 m2)<eGFR≤ 90 mL/(min·1.73 m2), n=28], according to eGFR results. Twenty-three cases with healthy physical examination were used as the control group. The liquid phase immunoprecipitation and transmission turbidity methods were used to detect 24-h urine albumin, and urinary albumin excretion rate (UAE) was calculated. The serum VEGF and HIF-1α levels were measured by ELISA. Results Serum levels of UAE, HIF-1α and VEGF were significantly higher in DKD1 and DKD2 groups than those in control group (P < 0.05). There was no significant difference in UAE levels between DKD1 and DKD2 groups (P>0.05). Serum levels of HIF-1α and VEGF were significantly higher in DKD2 group than those of DKD1 group (P<0.05). There were negative correlation between VEGF and HIF-1α levels with eGFR level (r=-0.59, P < 0.01; r=-0.55, P < 0.01). ROC curve showed that serum VEGF and HIF-1α levels were above the opportunity diagonal. The diagnostic sensitivities of HIF- 1 to DKD1 and DKD2 were 92.1% and 87.4%. The diagnostic specificities of HIF-1 to DKD1 and DKD2 were 91.7% and 85.4%. The diagnostic sensitivities of VEGF to DKD1 and DKD2 were 96.1% and 86.2%, and specificities were 93.3% and 89.1%. Conclusion Serum levels of VEGF and HIF-1α change with the severity of diabetic nephropathy are likely to be an early predictor for the progression of diabetic kidney disease.

Key words: diabetic nephropathies, vascular endothelial growth factors, hypoxia-inducible factor 1, alpha subunit, glomerular filtration rate, urinary albumin excretion