血清PAR ATF5 Smad3与2型糖尿病肾病患者肾功能指标血脂水平及预后的相关性分析

doi:10.3969/j.issn.1006-6233.2025.09.017

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摘要 目的: 探究血清血小板白蛋白比值(PAR)、激活转录因子5(ATF5)、Smad3与2型糖尿病肾病患者肾功能指标、血脂水平及预后的相关性。方法: 选择2019年12月至2022年1月于本院就诊的152例2型糖尿病肾病患者(糖尿病肾病组)和100例T2DM患者(单纯糖尿病组),糖尿病肾病组根据预后分为良好组(119例)与不良组(33例),Pearson分析糖尿病肾病组血清PAR、ATF5、Smad3与肾功能指标、血脂水平的相关性。Logistics分析2型糖尿病肾病患者预后影响因素。ROC分析血清PAR、ATF5、Smad3对2型糖尿病肾病患者预后的预测价值。结果: 与单纯糖尿病组相比,糖尿病肾病组UACR、PAR、ATF5、Smad3水平明显升高、eGFR水平明显降低(P<0.05);不良组血清PAR、ATF5、Smad3水平明显高于良好组(P<0.05)。血清PAR、ATF5、Smad3水平分别与UACR呈正相关(r=0.423、0.439、0.431,P<0.05)、分别与eGFR呈负相关(r=-0.408、-0.389、-0.396,P<0.05)。血清PAR、ATF5、Smad3水平升高是2型糖尿病肾病患者预后不良的危险因素(P<0.05)。血清PAR、ATF5、Smad3三者联合预测2型糖尿病肾病患者预后的AUC为0.919,敏感度84.85%,特异度89.92%,三者联合对2型糖尿病肾病患者预后的预测价值高于单独预测(Z三者联合-PAR=2.562、P=0.010,Z三者联合-ATF5=2.842、P=0.005,Z三者联合-Smad3=2.781、P=0.005)。结论: 2型糖尿病肾病患者血清PAR、ATF5、Smad3水平升高,并且三者分别与肾功能有一定相关性,三者联合检测对2型糖尿病肾病患者预后具有潜在预测价值。

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	笪晨星
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关键词 ： 2型糖尿病肾病, 血小板白蛋白比值, 激活转录因子5, Smad3

Abstract：Objective: To explore the correlation between serum platelet albumin ratio (PAR), activating transcription factor 5 (ATF5), Smad3 with renal function indicators, blood lipid levels and prognosis in patients with type 2 diabetes nephropathy. Methods: From December 2019 to January 2022, 152 patients with type 2 diabetes nephropathy (diabetes nephropathy group) and 100 patients with T2DM (simple diabetes group) who visited our hospital were selected. The diabetes nephropathy group was assigned into good group (119 cases) and poor group (33 cases) complying with the prognosis. Pearson method was used to analyze the correlation between serum PAR, ATF5, Smad3 with renal function indexes, blood lipid levels in diabetes nephropathy group. Logistic method was performed to analyze the prognostic factors of type 2 diabetes nephropathy patients. ROC was performed to analyze the prognostic value of serum PAR, ATF5, Smad3 in patients with type 2 diabetes nephropathy. Results: The diabetes nephropathy group had conspicuously higher UACR and PAR, ATF5 and Smad3, and conspicuously lower eGFR than the simple diabetes group (P<0.05). The poor group had conspicuously higher serum PAR, ATF5, and Smad3 than good group (P<0.05). Serum PAR, ATF5, and Smad3 were positively correlated with UACR (r=0.423, 0.439, 0.431, P<0.05) and negatively correlated with eGFR (r=-0.408, -0.389, -0.396, P<0.05), respectively. Elevated serum PAR, ATF5 and Smad3 were risk factors for poor prognosis of type 2 diabetes nephropathy patients (P<0.05). The AUC of serum PAR, ATF5 and Smad3 in predicting the prognosis of type 2 diabetes nephropathy patients was 0.919, with a sensitivity of 84.85% and a specificity of 89.92%. The predictive value of the combination of the three for the prognosis of type 2 diabetes nephropathy patients was higher than that of the single prediction (Zcombination-PAR=2.562, P=0.010, Zcombination-ATF5=2.842, P=0.005, Zcombination-Smad3=2.781, P=0.005). Conclusion: The serum PAR, ATF5 and Smad3 in type 2 diabetes nephropathy patients are elevated, and the three levels are respectively related to renal function. The combined detection of the three has potential predictive value for prognosis of type 2 diabetes nephropathy patients.

Key words： Type 2 diabetes nephropathy Platelet albumin ratio Activating transcription factor 5 Smad3

基金资助:国家自然科学基金,(编号:8180032171)

引用本文:

笪晨星, 杨姝洁, 许蒙蒙. 血清PAR ATF5 Smad3与2型糖尿病肾病患者肾功能指标血脂水平及预后的相关性分析[J]. 河北医学, 2025, 31(9): 1508-1514.
DA Chenxing, YANG Shujie, XU Mengmeng. Analysis of the Correlation between Serum PAR ATF5 Smad3 with Renal Function Index Blood Lipid Levels and Prognosis in Patients with Type 2 Diabetes Nephropathy. HeBei Med, 2025, 31(9): 1508-1514.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.09.017 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I9/1508

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