KLF4在糖尿病肾脏病Ⅲ～Ⅳ期肾精亏虚证中的表达和临床意义OACSTPCD

Objective To investigate the expression and clinical significance of KLF4 in the urine of patients with diabetic kidney disease(DKD),and to explore the relationship between KLF4 and the TCM pattern of kidney essence deficiency in DKD.Methods From January 2022 to March 2023,a total of 45 patients with stage Ⅲ-Ⅳ DKD,56 patients with type 2 diabetes mellitus(T2DM),and 44 healthy controls were enrolled at Dongzhimen Hospital affiliated with Beijing University of Chinese Medicine.Based on the diagnostic criteria for kidney essence deficiency,the DKD patients were divided into two groups:27 cases with kidney essence deficiency and 18 cases without.Differences in laboratory parameters and urinary KLF4 expression were compared.The correlation between KLF4 and clinical characteristics of DKD was analyzed using Pearson correlation analysis,DKD risk factors were assessed via Logistic regression analysis,and the diagnostic efficacy of KLF4 was evaluated with ROC curves.Results The expression level of KLF4 in the urine of patients with DKD was lower than that of healthy control group and T2DM group(P<0.05),and the level of KLF4 in urine of patients with DKD was positively correlated with eGFR(r=0.378,P<0.05),negatively correlated with Scr(r=-0.358,P<0.05),CysC(r=-0.388,P<0.05)and 24 h-UTP(r=-0.344,P<0.05)in correlation analysis.The expression level of KLF4 in urine of kidney-essence deficiency group was lower than that of non-kidney-essence deficiency group,which was negatively correlated with the score of kidney essence deficiency syndrome(r=-0.323,P<0.05).Logistic regression analysis suggested that KLF4 was a protective factor for DKD,but the diagnostic performance was generally moderate.Conclusion DKD patients,especially those with kidney essence deficiency,have abnormally low levels of urinary expression of KLF4.This finding suggests that KLF4 could potentially serve as a novel molecular marker for the non-invasive auxiliary diagnosis of DKD.