目的探讨血清脂蛋白(a)[LP(a)]与各因素的相关性及LP(a)检测在2型糖尿病肾病(T2DN)患者中的临床价值。方法选择2型糖尿病(T2DM)患者119例,其中单纯糖尿病患者36例(A组),糖尿病肾病(DN)患者83例(B组);正常对照组30例(NC组)。检测各组患者LP(a)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等生化指标,进行单一因素方差分析。119例糖尿病患者组以12(a)为因变量,与各检测指标作简单线性相关分析。采用受试者工作特征曲线(ROC曲线)分析并获得B组的最适临界点(cutoff值)。结果LP(a)水平在A组、B组升高明显(P〈0.01)。尿微量白蛋白(UMA)、GGT与LP(a)关系最密切。LP(a)ROC曲线下面积为0.818,在最适cutoff值为200mg/L时,灵敏度、特异度分别为77.4%、76.8%。结论Lp(a)与T2DN密切相关;可以被视为该疾病的一个独立危险因子,有可能成为T2DN的一个早期预防和监测指标。
Objective To investigate the relationship between Lipoprotein (a) [ LP (a) ] and each factor and its value in patients with type 2 diabetic nephro-pathy (T2DN). Methods 119 cases patients with type 2 diabetes mellitus (T2DM) were divided into two groups A (36 patients only with T2DM ) and B (83 patients with T2DN) and 30 normal controls were selected as NC group. The Levels of LP ( a), triglyceride (TG), total cholesterol ( TC ), high density lipoprotein cholesterol ( HDL-C ), low density lipoprotein ( LDL-C ) were measured. Receiver operating characteristic curve ( ROC curve) analysis was used to determine the optimal cutoff of patients in group B. Re-salts Compared with the NC group, LP(a) were increased obviously in A and B groups ( P 〈 0.01 ). LP(a) was closely related to urinary albumin (UMA) and γ-glutamyltransferase (GGT). The area under the ROC curve of LP(a) was 0. 818, and the optimal value of cutoff point was 200 mg/L ( sensitivity was 77. 4%, specificity was 76. 8% ). Conclusions LP(a) could be an independent risk factor for diabet-ic nephropathy and may become a marker to predict T2DN earlier.