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Objective To investigate the value of urinary α1-microglobulin (α1-MG) and N-acetyl-β-D-glucosaminidase/urinary creatinine (NAG/UCr) in monitoring renal injury in patients with chronic hepatitis B virus (HBV)-related liver diseases. Methods A total of 85 patients with HBV-related liver diseases who attended The Second Affiliated Hospital of Kunming Medical University from August 2019 to August 2020 were enrolled, and according to the history of treatment with nucleos(t)ide analogues (NUC), they were divided into NUC treatment group with 57 patients and non-NUC treatment group with 28 patients; according to the type of NUC used, the NUC treatment group was further divided into entecavir (ETV) treatment group with 32 patients and tenofovir disoproxil fumarate (TDF) treatment group with 25 patients; according to the results of HBV serum antigen and antibody markers, the patients were divided into HBeAg-negative group with 57 patients and HBeAg-positive group with 28 patients; according to the results of serum HBV DNA quantification, the patients were divided into HBV DNA-negative group with 47 patients and HBV DNA-positive group with 38 patients; according to abdominal imaging findings, the patients were divided into non-liver cirrhosis group with 47 patients and liver cirrhosis group with 38 patients. The data on medical history and laboratory markers were collected for comparison between two groups. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of data with skewed distribution between two groups; the chi-square test was used for comparison of categorical data between two groups. The McNemar test was used to compare the diagnostic merit of each index; a Spearman correlation analysis was used to investigate the correlation of each factor with α1-MG, and NAG/UCr; the multiple linear regression analysis was used to analyze the independent influencing factors for α1-MG and NAG/UCr. Results The non-NUC treatment group, the HBeAg-positive group, and the HBV DNA-positive group had significantly higher levels of urinary α1-MG than the NUC treatment group ( Z =-2.054, P =0.04), the HBeAg-negative group ( Z =-2.293, P =0.022), and the HBV DNA-negative group ( Z =-2.229, P =0.026), respectively. The HBV DNA-positive group and the liver cirrhosis group had significantly higher levels of NAG and NAG/UCr than the HBV DNA-negative group ( Z =-2.908 and -2.824, both P < 0.05) and the non-liver cirrhosis group ( Z =-3.204 and -3.412, both P < 0.05), respectively. There was a significant difference in the proportion of patients with abnormal α1-MG and that of patients with abnormal estimated glomerular filtration rate (eGFR) (31.8% vs 20.0%, χ 2 =7.178, P =0.007), and the proportion of patients with abnormal α1-MG and NAG/UCr was significantly higher than that of patients with abnormal eGFR (35.3% vs 20.0%, χ 2 =8.049, P =0.005). There was a significant difference in diagnostic merit between α1-MG+NAG/UCr and eGFR ( P =0.015). Age ( β =0.246, P < 0.05), positive HBeAg ( β =0.284, P < 0.01), and liver cancer ( β =0.291, P < 0.01) were independent risk factors for the increase in α1-MG, while the increase in FIB-4 value ( β =0.352, P < 0.05), ascites ( β =0.260, P < 0.05), esophagogastric varices( β =-0.248, P < 0.05), positive HBV DNA ( β =0.197, P < 0.05), and high total bilirubin ( β =0.257, P < 0.05) were independent risk factors for the increase in NAG/UCr. Conclusion In patients with chronic HBV-related liver diseases, renal injury may occur during the whole course of active viral replication, liver cirrhosis, and deterioration of liver function. Antiviral therapy with NUC can alleviate renal impairment caused by HBV and is safe and reliable within a certain course of treatment. Combined measurement of urinary α1-MG and NAG/UCr has more advantages over eGFR in the diagnosis of early renal injury, and it is an effective method for renal function monitoring in patients with chronic HBV-related liver diseases.
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Objective To explore the diagnostic value of serum cystitis C(CysC),urinary transferrin (UTRF)and urinary α1 microglobulin(α1MG)in the diagnosis of early diabetic nephropathy(DKD).Methods Totally 165 patients with diabetic mellitus treated in the hospital from January 2016 to January 2017 were selected,and then assigned to diabetic mellitus group(DM group)and diabetic kidney disease group(DKD group)based on urinary albumin excretion rate(UAER).83 healthy people were enrolled and assigned to con-trol group.The level of serum CysC,serum creatinine(SCr)and blood urea nitrogen(BUN)were detected by automatic biochemical analyzer,the level of UTRF,α1MG and microalbuminuria(MALB)were detected by lmmunoturbidimetry and then compare the variance in each group.Results Compared with the control group and DM group,the level of serum CysC,UTRF,α1MG and MALB were significantly increased in DKD group (P<0.05);The level of SCr and BUN in DKD group were increased but had no statistical significance com-pared with DM group(P> 0.05).Meanwhile,the positive detection rate of serum CysC,UTRF and α1MG were significantly higher than SCr and BUN(P<0.05).Serum Cys C,UTRF and α1MG showed positive cor-relation with MALB,SCr and BUN,the level of serum Cys C also showed a positive correlation with α1MG. The sensitivity of serum Cys C,UTRF and α1MG combined detection was 92.9%,which significantly higher than single maker detection(P<0.05).Conclusion The combined detection of serum cystitis C,urinary trans-ferrin and urinary α1 microglobulin have important value in the diagnosis of early diabetic kidney disease.
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Objective To explore the changes of detection of urine a1-MG and KNG1 in simple type 2 diabetes mellitus and diabetic nephropathy patients.Methods 66 cases of diabetic patients in General Hospital of Ningxia Medical University from September 2016 to March 2017 were recruited,and the patients were divided into two groups,as follows:the diabetic nephropathy (DN) group 34 cases as experimental group,and the simple type 2 diabetes mellitus (DM) group 32 cases as control group.Than DN group was divided into two groups according to HbAlc,A groups 19 cases HbAlc was less than 10％,B groups 15 cases HbAlc was greater than or equal to 10％.The urine α1-MG,urine KNG1 and other biochemical indicators were mearured for all subjects.Results Compared with the DM group,the urine α1-MG in DN group was significantly lower (t=9.972,P＜0.01),but the result of the urine KNG1 was the opposite (t=-3.356,P＜0.01).The urine α1-MG and serum GLU in B group were significantly higher than those of the A group (t=-2.092,-3.464,all P＜0.05),but the result of the serum Cr was the opposite (t=2.181,P＜0.05).The level of urine α1-MG in DN group were positively correlated with HbAlc and urine KNG1 (r=0.33,0.355,all P＜0.05).Conclusion There were some changes in the expression of urine α1-MG and KNG1 in the occurrence and development of diabetic nephropathy,which provide the basis for the clinical diagnosis of diabetic nephropathy.
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Objective To explore the expression level and the clinical significance of Cys C,β2-MG,α1-MG in pediatric patients with congenital hydronephrosis.Methods 98 pediatric patients definitely diagnosed with congenital hydronephrosis in the depart-ment of pediatric surgery and urology of our hospital were enrolled and assigned to group B.The blood samples were collected.Ad-ditionally,selected another 98 normal children as a control:group A.Then the expression level of Cys C,β2-MG andα1-MG were de-tected via ELLSA for the groups.Results With aggravation of hydronephrosis,the expression of Cys C,β2-MG andα1-MG elevated correspondingly.Moreover,compared to the control group,the expression of Cys C,β2-MG andα1-MG in the pediatric patients with different degrees had significant differences(P 0.05).Conclusion Cys C,β2-MG and α1-MG can be used for evaluating the hydronephrosis and renal impair-ment.And it has more important significance by combining them.
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Objective To study the potential use of the urinary beta-trace protein ( βTP) for diagnosis of type 2 diabetic renal injury.Methods 174 patients with type 2 diabetic mellitus (T2DM) were classified into 2 groups according to the ratio of urinary albumin to creatinine (Alb/Cr):diabetes without renal injury group (group A) and diabetes with renal injury group (group B).70 healthy subjects served as normal control group ( group C).The level of urinary βTP and αl microglobulin (α1MG) was measured by latex particle enhanced immunoturbidimetry assay.The urinary Alb and Cr were determined by nephelometry and Jaffe method respectively.The level of uriuary βTP among all groups was compared and ROC curve analysis was performed.The relevant analysis on urinary βTP,urinary α1MG and other related indexes was made.Results The median level of urinary βTP/Cr in group B was 9.1mg/g Cr,significantly higher than 3.1mg/g Cr of group A and 2.0mg/g Cr of group C.The difference had statistical significance ( H =45.5,P ＜ 0.01).The other indexes ( Alb/Cr,α1MG/Cr,SCr) were all higher in group B than in the other 2 groups ( H =110.9,38.3,11.4 respectively,P ＜0.01).The relevant analysis showed that urinary βTP/Cr was positively correlated with urinary α1MG/Cr (r =0.894,P ＜ 0.01),SCr (r =0.367,P ＜ 0.05 ),HbA(J) C ( r =0.242,P ＜ 0.05 ),systolic pressure ( r =0.162,P ＜0.05 ),and the course of the disease ( r =0.251,P ＜ 0.05 ).No correlation was found between urinary βTP/Cr and diastolic pressure,fasting blood glucose(FBG) or BMI.ROC curve analysis showed the area under the curve (AUC) was 0.86 (95％CI,0.78-0.93)for urinary βTP/Cr and 0.76 (95％ CI,0.67-0.85) for urinary α1MG/Cr.The best cut-off value of urinary βTP/Cr and α1MG/Cr was 4.1mg/g Cr vs 10.9mg/g Cr,the sensitivity was 68.5％ vs 59.7％,and the specificity was 89.8％ vs 80.3％.The difference had statistical significance (P ＜ 0.05).Conclusions Urinary βTP has better diagnostic value for type 2 diabetic patients with renal injury than urinary α1MG.It can sensitively reflect renal tubular injury and can be used as a novel available biomarker to evaluate the renal tubular injury in clinic.