| Objective:By detecting The levels of urine aquaporin 5(AQP5)and serum cystatin C(Cys C)in patients with type 2 diabetes mellitus nephropathy(DN),to analyze its correlation with clinical biochemical indexes,and to explore its value in DN.Methods:From January 2018 to August 2019,132 patients with type 2 diabetes mellitus(T2DM)were selected.All T2DM patients were divided into normal albuminuria group,early DN group and clinical DN group according to the urine albumin/creatinine(ACR)level.In addition,40 age and gender matched healthy persons were selected as the control group.The level of AQP5 in urine was detected by enzyme-linked immunosorbent assay(ELISA),and the levels of Cys C were detected by immunoturbidimetry.The levels of urinary AQP5 and serum Cys C were compared.The correlation between urinary AQP5,serum Cys C and clinical biochemical indexes was analyzed.Results:1.The level of urinary AQP5 and serum Cys C in the normal albuminuria group was higher than that in the healthy control group,but the difference was not statistically significant(P>0.05),while the level of urinary AQP5 and serum Cys C in the early DN group was higher than that in the healthy control group and the normal albuminuria group(P<0.01,P<0.05),and the level of urinary AQP5 and serum Cys in the clinical DN group was statistically significant(P<0.01,P<0.05)The level of serum Cys C was higher than that of control group,normal albuminuria group and early DN group(P<0.01).2.Urine AQP5 level and serum Cys C level in patients with DN were positively correlated with BUN and Scr(P<0.01),and negatively correlated with GFR(P<0.01),but not significantly correlated with age and course of disease(P>0.05).3.Urine AQP5 level in patients with DN was positively correlated with serum Cys C level(r=0.335,P=0.001).4.The area under the ROC curve of the accuracy of urine AQP5 in diagnosis of early DN was 0.763,and the accuracy of diagnosis of early DN was moderate.The area under the curve of the accuracy of serum Cys C in diagnosis of early DN was 0.896,and the accuracy of diagnosis of early DN was moderate.5.The area under the ROC curve of the combined detection and diagnosis of early DN by urine AQP5 and serum Cys C was 0.947.The accuracy of diagnosis of early DN was relatively high,which was better than the detection of urine AQP5 or serum Cys C alone.6.The number of positive urine AQP5 detected in 50 cases of early DN patients was 28,with a positive rate of 56%.The number of positive cases of serum Cys C in 50 cases of early DN was 31,and the positive rate was 62%.The combined detection of urine AQP5 and serum Cys C in 50 cases of early DN was positive in 38 cases,with a positive rate of 76%.7.There was no significant difference between the detection of urine AQP5 alone and the detection of serum Cys C alone in diagnosis of early DN(P>0.05),while the difference between the detection of urine AQP5 and serum Cys C in the combined detection of urine AQP5 and serum Cys C in diagnosis of early DN was statistically significant(P<0.01).Conclusion:1.AQP5 may be involved in the occurrence and development of DN,and urine AQP5 level may reflect the degree of renal injury in patients with DN to some extent.2.Urine AQP5 and serum Cys C can be used as markers for diagnosis of early DN.3.At the diagnosis of early DN,the diagnostic accuracy of the combined detection of urine AQP5 and serum Cys C was significantly better than that of the alone detection of urine AQP5 or serum Cys C. |
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