Diagnostic Signifcance Of Assay Of Serum Retinal-binding Protein In Early Diabetic Nephropathy

ObjectiveDiabetic Nephropathy (DN) is one of the most familiar micrangium complications of Diabetes mellitus(DM), the basic pathologic feature of which includes glomerular sclerosis and abnormal variation of urine protein. With no ideal treatment measures yet, it is a main cause of disability and death to DM suffers. So early detection of DN is of particular importance for prevention of end-stage DN. As an urgent clinical need to address, early diagnosis of DN has won attention of scholars both at home and abroad in recent years. With joint detection of serum etinol-birnding protein (sRBP) and microalbumin (mAlb), the value of serum retinol conjugated protein in early diagnosis of DN is herein discussed. The objective of this research is as follows:1.To observe the variance of Serum retinol-binding protein(sRBP),Microalbumin(mAlb),Immunoglobulin G (IgG),α1-microglobuin (αl-m),Transferrin(TRF),Glycosylated haemoglo-binAlc (GHbAlc,Total cholesterol (TC),Triglyceride(TG),Low density lipoprotein (LDL),High density lipopr-otein (HDL),Fasting plasma glucose(FPG) et al a series of index in T2DM and DN.2.To study the relationship between the concentration of sRBP,mAlb and the D N, so that we can reach the objective of the prevention and treatment of vascular complications in DN patients.3. To know the relationship between concentration of sRBP,mAlb and all factors.Method1. research objects:62 patients of T2DM who were in the endocrinology department of Qian Fo Shan Hospital were observed between Januany 2009 and December 2009,32 men and 30 wemen were included, their average age is (58.39±11.31) years.The diagnostic criteria of T2DM is according to the diagnostic criteria which is accepted by WHO in 1999.The course of these patients is between 1 month to 14 years.The patients were divided into two groups According to the two items of urine protein negative and urine protein> 30mg/L in routine uronoscopy, they are divided into two groups. The former group (Group A) includes 30 objects with the average age of 58.50±13.81; the latter group (Group B) includes 32 objects with the average age of 58.28±8.55. The control group (Group C) includes 31 objects with the average age of 54.10±9.69, who has no medical history of hypertension, nephrosis or DM and their urine protein indicates negative in routine uronoscopy.2. The determination of the indicators:All the patients were tested their SBP,DBP,FPG,GHbAlc,TC,TG,LDL and HDLet al a series of index.The serum level of RBP examed by the method of immunune transmission nephelometry, and the level of mAlb,IgG,α1-m,and TRF was tested by using the method of nephelometry.3. Statistics:SPSS 17.0 software was adopted to carry out the data processing and analyses.Results1. The sRBP levels were much higher in group A and B than group C (P<0.01), The group A demonstrate:the sRBP levels in males were higher than in females in each group (P<0.05), but had no significant differences between group B and group C (P>0.05)2. The level of TC,TG and LDL was higher in in group A and B than group C (P<0.01), the difference between these two groups has statistic significance (P<0.01), but had no significant differences between group A and group B (P>0.05)3. The level of mAlb,IgG,α1-m and TRF was higher in group A than that in group C(P<0.01). The level of mAlb,IgG and TRF was higher in group A than that in group B(P<0.01), but had no significant differences between group B and group C (P>0.05). The level ofα1-m had no significant differences between group A and group B (P>0.05),but had significant differences between group B and group C (P<0.05)4. The linear correlation analysis revealed that the level of sRBP in group A with the level of mAlb (r=0.47,P<0.01),TG (r=0.38,P<0.05) were positive correlated. The level of sRBP in group B with the level of TC (r=0.49,P<0.01),TG (r=0.38,P<0.05) and LDL (r=0.41,P<0.05) were positive correlated.Conclusion1. There is a close correlation between the level of sRBP and mAlb in DN. The level of sRBP gradually increased with the progressive DN. They may be the marks of DN. The early examination of the level of sRBP can predict the occurrence and development of the DN.2. The level of sRBP has a correlation with TG in DN,and has a correlation with TC,TG,LDL in T2DM,show that it has a correlation with lipids metabolism,especially with TG.