| Objective To investigate the changes and the clinical value of serum pentraxin 3 and α-klotho protein levels in patients with type 2 diabetic kidney disease. Methods A total of 174 type 2 diabetic patients admitted to the Department of Endocrinology of the Baoding First Central Hospital from November 2016 to November 2018 and 55 healthy people (NC group) who were examined in the hospital during the same period were selected as the research objects in this study. We grouped the diabetes patients into three groups:normal albuminuria group (DM group, n=60),microalbuminuric patients (DKD1 group, n=61) and macroalbuminuric patients (DKD2 group, n=53),referring to the WHO recommended staging criteria for diabetic kidney disease.The serum levels of pentraxin 3 and α-klotho protein in each group of subjects were detected by ELISA. Spearman correlation analysis was used to understand the related factors of pentraxin 3 and α-klotho protein. Multiple linear regression was used to analyze the correlation of serum pentraxin 3 and α-klotho protein.The diagnostic value of the two indicators was analyzed by plotting the receiver operating characteristic curve. Results The results of serum pentraxin 3 concentration comparison in each group showed that the pentraxin 3 levels inthree groups of diabetic patients were higher than those in NC group, among which the DKD2 group was the highest(P<0.05). The serum levels of α-klotho protein in DM group was lower than that in NC group.The serum levels of α-klotho protein in DKD1 group and DKD2 group were significantly lower than those in DM group, and those in DKD2 group were the lowest(P<0.05).Spearman correlation analysis showed that serum pentraxin 3 levels were positively correlated with duration of diabetes, sCr, BUN, FBG, HbA1c, HOMA-IR, UALB, UAER, UACR, 24 h urine protein (r=0.152,0.287,0.312,0.543,0.609,0.492,0.549, 0.588,0.619,0.422,P<0.05), and negatively correlated with eGFR, ALB, and α-klotho protein (r=-0.402,-0.541,-0.933,P<0.05). The serum α-klotho protein levels had a positive linear correlation with eGFR, TP and ALB (r=0.352,0.201,0.532), and negative linear correlation with duration of diabetes, sCr, BUN, FBG, HbA1c, HOMA-IR,UACR, 24h urine protein and pentraxin 3 (r=-0.156,-0.359,-0.318,-0.533,-0.621,-0.528,-0.872,-0.632,-0.933, P<0.05). Multiple linear regression analysis showed that UACR and eGFR were independent factors of pentraxin 3 and α-klotho protein (P<0.05). ROC analysis showed that the area under the curve of serum pentraxin 3 and α-klotho protein were 0.84 and 0.95, respectively. Both pentraxin 3 and α-klotho protein provide assistance in the diagnosis of diabetic kidney disease. Since the sensitivity of pentraxin 3 and α-klotho proteinwas 67.5% and 95.6%, respectively, α-klotho protein had higher sensitivity than pentraxin 3did. Conclusion With the progress of the disease,both elevated pentraxin 3 level and decreased α-klotho protein can be found in patients with type 2 diabetic kidney disease. Serum pentraxin 3 and α-klotho protein are mutually independent factors, which may provide a new direction for early screening and treatment of diabetic kidney disease. |
