ABSTRACT
Objective:To investigate the relationship between serum retinol binding protein (RBP), stromal cell derived factor-1 (SDF-1) and renal function in patients with diabetic nephropathy (DKD).Methods:The patients with type 2 diabetes mellitus (T2DM) admitted to Yantai Affiliated Hospital of Binzhou Medical College from October 2017 to October 2020 were prospectively selected, 438 patients were divided into simple T2DM group ( n=276)and DKD group( n=162) according to the presence or absence of DKD, according to the ratio of urinary albinin/creatinine (UACR) were divided into normal( n=25), microalbuminuria ( n=75) and macroalbuminuria group ( n=62), according to the estimated glomerular filtration rate (eGFR) were divided into G1 stage ( n=28), G2 stage ( n=27), G3A + G3B stage ( n=35), G4 stage ( n=39)and G5 stages( n=33). The relationship between RBP, SDF-1 and renal function index UACR, serum uric acid (UA), blood urea nitrogen (BUN), β 2-microglobulin (β 2-MG) and serum creatinine (Scr) was analyzed. Measurement data of normal distribution were expressed as Mean± standard deviation ( Mean± SD). Independent sample t-test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups.Chi-square test was used to compare the enumeration data between groups. Receiver operating characteristic curve (ROC) was used to analyze the discriminant value of RBP and SDF-1 for DKD. Pearson was used for correlation analysis among indicators. Multivariate linear regression analysis was used to analyze the influencing factors of RBP. Results:In the DKD group, the duration of diabetes was longer, the levels of RBP, UACR, UA, BUN, β 2-MG, Scr were high, SDF-1 and eGFR were lower, with statistically significant differences compared with the simple T2DM group( P<0.05).The areas under the curve of RBP and SDF-1 to distinguish DKD were 0.903 and 0.868, and the optimal cut-off values was 70.71 mg/L and 5.69 ng/mL. With the increase of urinary albumin and clinical stage, the levels of RBP, UACR, UA, BUN, β 2-MG, Scr increased gradually, while SDF-1 and eGFR decreased gradually, and the differences were statistically significant ( P<0.05).RBP was positively correlated with UACR, UA, BUN, β 2-MG and Scr in DKD patients ( r=0.764, 0.787, 0.693, 0.577, 0.801, P<0.000 1), and negatively correlated with EGFR ( r=-0.782, P<0.000 1). SDF-1 was negatively correlated with UACR, UA, BUN, β 2-MG and Scr ( r=-0.744, -0.794, -0.666, -0.605, -0.820, P<0.000 1), and positively correlated with EGFR ( r=0.767, P<0.000 1). The multiple linear regression equation was RBP=29.852+ 0.007UACR+ 0.101UA+ 0.497BUN+ 0.034Scr-0.083eGFR ( P<0.001). Conclusion:RBP and SDF-1 have certain discriminant value for DKD patients in T2DM population, and the degree of DKD renal function injury is positively correlated with RBP and negatively correlated with SDF-1, the increase of UACR, UA, BUN, Scr and the decrease of eGFR are risk factors for the increase of RBP.
ABSTRACT
Objective:To explore the differences of leukocyte subtypes and thyroid function of the patients with different thyrotoxicosis diseases,and to clarify the practical significance of leukocyte subtypes and thyroid function tests in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis.Methods:A total of 33 patients with Graves disease thyrotoxicosis and 30 patients with destructive thyrotoxicosis confirmed by clinical and laboratory examination were selected; the levels of neutrophils (Ne),lymphocyte (Ly),basophils (Ba), eosinophil (Eo)and mononuclear cells (Mo),serum free thyroxine (FT4),three free iodine thyroid former glycine (FT3),and thyroid stimulating hormone (TSH)of the patients in two groups were analyzed and the receiver operator characteristic curve (ROC)was used to evaluate the values of the indicators with statastical significance in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis.Results:The levels of serum Eo,FT4 and FT3,and the modified data Eo/Mo,Eo × FT3 / Mo of the patients in Graves disease thyrotoxicosis group were significantly higher than those in destructive thyrotoxicosis group (P <0.05);the levels of TSH and Mo of the patients were lower than those in destructive thyrotoxicosis group (P < 0.05).The ROC curve analysis results showed that the sensitivities and specificities of Eo,Eo/Mo,Eo×FT3/Mo in the differential diagnosis of two diseases were good, and the best diagnostic boundaries were 1.54, 0.34, and 3.94. Conclusion:Eo,Mo,TSH,FT3,FT4,Eo/Mo,and EoxFT3/Mo could be regarded as the basis in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis ,and the practical significances of Eo,Eo/Mo,and Eo×FT3 /Mo in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyotoxicosis are bigger.