CAJ | 학술논문

目的：探讨尿肝型脂肪酸结合蛋白（ L-FABP）与糖尿病肾病进展的关系。方法选择1型和2型糖尿病患者132例，依据尿蛋白/肌酐比（ACR）和血清肌酐水平分为正常蛋白尿组（45例），微量蛋白尿组（36例），临床白蛋白尿组（30例），肾功能衰竭组（21例），以65例健康体检者为对照组，酶联免疫吸附法（ ELISA ）测定尿L-FABP含量，同时检测血肌酐（Scr）、尿肌酐、肝功能、血红蛋白、糖化血红蛋白（HbA1c）、白蛋白（Alb）、24 h尿蛋白量、尿白蛋白等指标。结果随着糖尿病肾病的进展，尿L-FABP水平逐渐增高（各组间比较P ＜0.01），亚组分析显示正常白蛋白组尿L-FABP水平高于健康组（ P＜0.05），微量白蛋白组尿L-FABP水平高于正常白蛋白组（ P ＜0.01），临床白蛋白组尿L-FABP水平高于微量白蛋白组（ P＜0.01），肾功能衰竭组尿L-FABP水平高于临床白蛋白组（ P ＜0.01）；尿L-FABP水平与估计肾小球滤过率（ eGFR ）呈负相关（ r ＝-0.812， P ＜0.01），尿L-FABP水平与Scr呈正相关（ r ＝0.901， P ＜0.01），与HbA1c无关（ P ＞0.05）。结论尿L-FABP水平不但可以更早预测糖尿病肾病的发生，还可以监测糖尿病肾病的进展。
목적：탐토뇨간형지방산결합단백（ L-FABP）여당뇨병신병진전적관계。방법선택1형화2형당뇨병환자132례，의거뇨단백/기항비（ACR）화혈청기항수평분위정상단백뇨조（45례），미량단백뇨조（36례），림상백단백뇨조（30례），신공능쇠갈조（21례），이65례건강체검자위대조조，매련면역흡부법（ ELISA ）측정뇨L-FABP함량，동시검측혈기항（Scr）、뇨기항、간공능、혈홍단백、당화혈홍단백（HbA1c）、백단백（Alb）、24 h뇨단백량、뇨백단백등지표。결과수착당뇨병신병적진전，뇨L-FABP수평축점증고（각조간비교P ＜0.01），아조분석현시정상백단백조뇨L-FABP수평고우건강조（ P＜0.05），미량백단백조뇨L-FABP수평고우정상백단백조（ P ＜0.01），림상백단백조뇨L-FABP수평고우미량백단백조（ P＜0.01），신공능쇠갈조뇨L-FABP수평고우림상백단백조（ P ＜0.01）；뇨L-FABP수평여고계신소구려과솔（ eGFR ）정부상관（ r ＝-0.812， P ＜0.01），뇨L-FABP수평여Scr정정상관（ r ＝0.901， P ＜0.01），여HbA1c무관（ P ＞0.05）。결론뇨L-FABP수평불단가이경조예측당뇨병신병적발생，환가이감측당뇨병신병적진전。
Objective To investigate the relationship of urinary liver-type fatty-acid binding protein and progression of ne-phropathy in diabetic patients .Methods A total of 132 cases of type 1 and type 2 diabetic patients were recruited in this study , and were divided into four groups based on the urine albumin /creatinine and serum creatinine levels , including normal albuminuria group ( n =45), microalbuminuria group ( n =36), clinical albuminuria group ( n =30), and renal failure group ( n =21), Additional 65 healthy subjects were recruited as control group .The levels of urinary liver-type fatty-acid binding protein ( L-FABP) were measured with enzyme-linked immunosorbent assay (ELISA), and serum creatinine, urine creatinine, Liver function, hemoglobin, glycated he-moglobin (HbA1c), albumin (Alb), and 24h urinary protein were measured by respective biochemical or immunological methods . Results With the progression of diabetic nephropathy , the level of urinary L-FABP was gradually increased ( P <0.01 ) , subgroup analysis showed that the level of urine L-FABP of normal albuminuria group was significantly higher than that of healthy group ( P <0.05 ) .The level of urine L-FABP of microalbuminuria group was significantly higher than that of normal albuminuria group ( P <0.01 ) .The level of urine L-FABP of clinical albuminuria group was significantly higher than that of microalbuminuria group ( P <0.01 ) .The level of urine L-FABP of renal failure group was significantly higher than that of clinical albuminuria group ( P <0.01 ) . The levels of urinary L-FABP was negatively correlated with estimated glomerular filtration rate ( eGFR) ( r =-0.812 , P <0.01 ) , was positively correlated with Scr ( r =0.901, P <0.01), and was no correlation with HbA1c ( P >0.05).Conclusions The uri-nary L-FABP level can predict the occurrence of early diabetic nephropathy , and also monitor the progression of diabetic nephropathy .