中国现代医学杂志2025，Vol.35Issue(15)：16-22,7.DOI:10.3969/j.issn.1005-8982.2025.15.003
外周血β2微球蛋白、TFF3、Lp-PLA2对老年2型糖尿病患者早期肾功能损害及蛋白尿进展的评估价值
Evaluation value of peripheral blood β2-microglobulin,TFF3,and Lp-PLA2 in assessing early renal impairment and proteinuria progression in elderly patients with type 2 diabetes mellitus
摘要
Abstract
Objective To evaluate the value of peripheral blood β2-microglobulin(β2-m),trefoil factor 3(TFF3),and lipoprotein-associated phospholipase A2(Lp-PLA2)in assessing early renal function impairment and proteinuria progression in elderly patients with type 2 diabetes mellitus(T2DM).Methods Ninety-seven elderly T2DM patients admitted to Handan First Hospital from March 2021 to May 2024 were enrolled.According to the Mogensen diabetic nephropathy(DN)staging criteria,patients were divided into stage Ⅲ group(n=35),stage Ⅳ group(n=20),stage Ⅴ group(n=11),and non-DN group(n=31).Serum levels of β2-m,TFF3,and Lp-PLA2 were compared between patients with early renal impairment(stages Ⅲ-Ⅴ)and the non-DN group.Spearman correlation analysis was used to assess the relationships between serum β2-m,TFF3,Lp-PLA2 levels and early renal impairment.Patients were further divided into a progression group(n=23,developed proteinuria progression)and a non-progression group(n=74).Multivariate logistic regression was performed to identify factors influencing proteinuria progression.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of β2-m,TFF3,and Lp-PLA2.Results Serum β2-m,TFF3,and Lp-PLA2 levels in the stage V group were significantly higher than those in the stage Ⅲ,stage Ⅳ,and non-DN groups(P<0.05).Levels in the stage Ⅳ group were significantly higher than those in the stage Ⅲ and non-DN groups(P<0.05).Levels in the stage Ⅲ group were significantly higher than those in the non-DN group(P<0.05).Spearman analysis revealed positive correlations between serum β2-m,TFF3,Lp-PLA2 levels and early renal impairment(r=0.512,0.508,0.594 respectively,P<0.05).The progression group had a higher metformin usage rate,serum creatinine(Scr),β2-m,TFF3,and Lp-PLA2 levels compared to the non-progression group(P<0.05).Multivariate logistic regression identified metformin use[(O^R)=4.821(95％CI:2.119,10.967)],high β2-m[(O^R)=5.217(95％CI:2.294,11.869)],high TFF3[(O^R)=4.112(95％CI:1.808,9.355)],and high Lp-PLA2[(O^R)=3.777(95％CI:1.660,8.593)]as independent risk factors for proteinuria progression(P<0.05).ROC analysis showed that the sensitivities of β2-m,TFF3,Lp-PLA2,and their combination for predicting progression were 78.26％(95％CI:0.725,0.874),82.61％(95％CI:0.818,0.935),91.30％(95％CI:0.856,0.991),and 91.30％(95％CI:0.851,0.996),respectively;specificities were 85.14％(95％CI:0.783,0.961),83.78％(95％CI:0.764,0.946),72.97％(95％CI:0.654,0.816),and 93.24％(95％CI:0.883,0.998),respectively.The areas under the curve were 0.799(95％CI:0.682,0.915),0.843(95％CI:0.721,0.967),0.796(95％CI:0.679,0.912),and 0.909(95％CI:0.778,1.043),respectively,indicating higher predictive value for the combination.Conclusion Serum β2-m,TFF3,and Lp-PLA2 levels are positively correlated with early renal impairment in elderly T2DM patients.These biomarkers hold significant value in predicting proteinuria progression,with the combination demonstrating superior predictive efficacy.关键词
2型糖尿病/肾功能损害/β2微球蛋白/三叶因子3/脂蛋白相关磷脂酶A2/老年/蛋白尿进展/预测价值Key words
type 2 diabetes/renal function impairment/β2-microglobulin/trefoil factor 3/lipoprotein-associated phospholipase A2/elderly/proteinuria progression/predictive value分类
医药卫生引用本文复制引用
吕晓伟,刘倩,周欢欢,谢文垚,牛尚梅,韩世超..外周血β2微球蛋白、TFF3、Lp-PLA2对老年2型糖尿病患者早期肾功能损害及蛋白尿进展的评估价值[J].中国现代医学杂志,2025,35(15):16-22,7.基金项目
河北省自然科学基金(No:H2022110019) （No:H2022110019）
