|本期目录/Table of Contents|

[1]王雅文,张盈莹,牛文彦.血清Angpt-2、Angptl4和尿KIM-1水平对早期糖尿病肾脏疾病的诊断价值[J].天津医科大学学报,2026,32(02):160-164.[doi:10.20135/j.issn.1006-8147.2026.02.0160]
 WANG Yawen,ZHANG Yingying,NIU Wenyan.Diagnostic value of serum Angpt-2, Angptl4 and urinary KIM-1 level in early-stage diabetic kidney disease[J].Journal of Tianjin Medical University,2026,32(02):160-164.[doi:10.20135/j.issn.1006-8147.2026.02.0160]
点击复制

血清Angpt-2、Angptl4和尿KIM-1水平对早期糖尿病肾脏疾病的诊断价值(PDF)

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
32卷
期数:
2026年02期
页码:
160-164
栏目:
临床医学
出版日期:
2026-03-20

文章信息/Info

Title:
Diagnostic value of serum Angpt-2, Angptl4 and urinary KIM-1 level in early-stage diabetic kidney disease
文章编号:
1006-8147(2026)02-0160-05
作者:
王雅文张盈莹牛文彦
(天津医科大学朱宪彝纪念医院检验科,天津市内分泌研究所,国家卫健委激素与发育重点实验室,天津市代谢性疾病重点实验室,天津 300134)
Author(s):
WANG Yawen ZHANG Yingying NIU Wenyan
(Department of Laboratory, Tianjin Medical University Chu Hsien-I Memorial Hospital, Tianjin Institute of Endocrinology, Key Laboratory of Hormones and Development of the National Health Commission, Tianjin Key Laboratory of Metabolic Diseases, Tianjin 300134, China)
关键词:
血管生成素-2血管生成素样蛋白 4肾损伤分子-1糖尿病肾脏疾病
Keywords:
angiopoietin-2 angiopoietin-like protein 4 urinary kidney injury molecule-1 diabetic kidney disease
分类号:
R587.2
DOI:
10.20135/j.issn.1006-8147.2026.02.0160
文献标志码:
A
摘要:
检测糖尿病肾脏疾病患者血清血管生成素-2(Angpt-2)、血管生成素样蛋白4(Angptl4)和尿肾损伤分子-1(KIM-1)水平,探究其在早期糖尿病肾脏疾病中的诊断价值。方法:分析2024年10月—2025年5月在天津医科大学朱宪彝纪念医院就诊的105例2型糖尿病患者临床资料,依据尿微量白蛋白/肌酐比值(ACR)的Mogensen分期标准将所有患者划分为:正常白蛋白尿组(NA组)、微量白蛋白尿组(MA组)和临床白蛋白尿组(CA组),每组各35例。同时从本医院同期健康体检者中随机抽样阴性对照组(NC组) 35名。对各组一般生化指标和肾损伤相关指标进行比较,通过受试者工作特征(ROC)曲线评价血清Angpt-2、Angptl4和尿KIM-1单独及联合检测对早期糖尿病肾脏疾病的诊断价值。结果:尿KIM-1水平与ACR呈正相关(H= 79.81,P<0.01);而血清Angpt-2、Angptl4水平与ACR呈负相关(H=49.52、40.39,均P<0.01)。在诊断效能方面,尿KIM-1、血清Angpt-2、Angptl4单独检测的曲线下面积(AUC)分别为0.909、0.799、0.682,95%CI依次为0.861~0.958、0.727~ 0.871、0.593~0.771。当3个指标联合诊断糖尿病肾脏疾病时,AUC提升至0.935(95%CI: 0.896~0.974)。结论:血清Angpt-2、Angptl4和尿KIM-1的单独检测均对早期糖尿病肾脏疾病的诊断具有临床意义,而三者联合检测将进一步提高诊断能力。
Abstract:
Objective: To determine the levels of serum angiopoietin-2(Angpt-2), angiopoietin-like protein 4 (Angptl4), and urinary kidney injury molecule-1 (KIM-1) in patients with diabetic kidney disease (DKD), and investigate their clinical diagnostic value in early-stage DKD. Methods: The clinical data from 105 patients with type 2 diabetes mellitus admitted to Chu Hsien-I Memorial Hospital of Tianjin Medical University from October 2024 to May 2025 were analyzed. According to the Mogensen staging criteria based on the urinary albumin-to-creatinine ratio (ACR), all patients were divided into three groups: the normal albuminuria group (NA group), microalbuminuria group (MA group), and clinical albuminuria group (CA group), with 35 cases in each group. Additionally, 35 healthy individuals from routine health examinations during the same period were randomly selected as a negative control group (NC group). The general biochemical parameters and kidney injury-related indicators were compared among the groups. The diagnostic value of serum Angpt-2, Angptl4, and urinary KIM-1, both individually and in combination, for early-stage DKD was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Urinary KIM-1 levels showed a positive correlation with ACR (H=79.81, P<0.01). In contrast, serum Angpt-2 and Angptl4 levels were negatively correlated with ACR (H=49.52, 40.39, both P<0.01). Regarding diagnostic performance, the areas under the curve (AUC) for urinary KIM-1, serum Angpt-2, and Angptl4 alone were 0.909, 0.799, and 0.682, respectively, with 95% confidence intervals (CI) of 0.861-0.958, 0.727-0.871, and 0.593-0.771. When these three markers were combined for the diagnosis of DKD, the AUC increased to 0.935 (95% CI: 0.896-0.974). Conclusion: The individual measurement of serum Angpt-2, Angptl4, and urinary KIM-1 holds clinical significance for the diagnosis of early-stage DKD. Furthermore, the combined detection of these three biomarkers can further enhance the diagnostic capability.

参考文献/References:

[1] 王子宜,戴恩来. 糖尿病肾病进展的生物学标记研究进展[J]. 临床肾脏病杂志,2020,20(6):513-518.
[2] PELLE M C, PROVENZANO M, BUSUTTI M, et al. Up-date on diabetic nephropathy[J]. Life (Basel), 2022,12 (8):1202.
[3] SHLIPAK M. Diabetic nephropathy[J]. BMJ Clin Evid, 2009, 2009: 0606.
[4] SAMANN A, WOLF G. Diabetic nephropathy[J]. Internist, 2012, 53(10):1195-1206.
[5] SALEM N A, ISMAIL W M, HENDAWY S R, et al. Serum angio-poietin-2: a promising biomarker for early diabetic kidney disease in children and adolescents with type 1 diabetes[J]. Eur J Pediatr, 2024,183 (9):3853-3862.
[6] BANO G, IMAM M T, BAJPAI R, et al. Expression of angiopoetin-like protein-4 and kidney injury molecule-1 as preliminary diagnostic markers for diabetes-related kidney disease: a single center-based cross-sectional study[J]. J Pers Med, 2023,13 (4):577.
[7] 中华医学会糖尿病学分会. 中国糖尿病防治指南(2024版)[J]. 中华糖尿病杂志,2025,17(1): 16-139.
[8] LEVEY A S, INKER L A, CORESH J. GFR estimation: from physiology to public health[J]. Am J Kidney Dis, 2014,63(5):820-834.
[9] 俞灵琦. 上海打造全球糖尿病诊治中国方案的探索与实践[J]. 华东科技,2025,43( 8):12-21.
[10] IKIZLER T A, BURROWES J D, BYHAM-GRAY L D, et al. KDOQI clinical practice guideline for nutrition in CKD: 2020 update[J]. Am J Kidney Dis, 2020,76 (3 Suppl 1):S1-S107.
[11] HANDU D, ROZGA M, STEIBER A. Executive summary of the 2020 academy of nutrition and dietetics and national kidney foundation clinical practice guideline for nutrition in CKD[J]. Acad Nutr Diet,2021,121(9):1881-1893.
[12] RICO-FONTALVO J, AROCA-MART?魱NEZ G, DAZA-ARNEDO R, et al. Novel biomarkers of diabetic kidney disease[J]. Biomole-cules, 2023,13(4):633.
[13] THIPSAWAT S. Early detection of diabetic nephropathy in patient with type 2 diabetes mellitus: a review of the literature[J]. Diab Vasc Dis Res, 2021,18 (6):14791641211058856.
[14] 《糖尿病肾脏病早期筛查与管理专家共识》编写组. 糖尿病肾脏病早期筛查与管理专家共识(2025版)[J]. 中华糖尿病杂志,2025, 17(7):786-800.
[15] SHI A, MANSOUR S G. The role of vascular biomarkers in outcomes of patients with kidney disease[J]. Nephron, 2023,147(12):778-781.
[16] ALSHAWAF E, ABU-FARHA M, MOHAMMAD A, et al. Angio-poietin-2 and angiopoietin-like proteins with a prospective role in predicting diabetic nephropathy[J]. Biomedicines, 2024,12(5):949.
[17] GUO K, PAN P, WU M, et al. Hyposialylated angiopoietin-like-4 induces apoptosis of podocytes via β1 integrin/FAK signaling in diabetic nephropathy[J]. Mol Cell Endocrinol, 2020,505:110730.
[18] SRIVASTAVA S P, ZHOU H, SHENOI R, et al. Renal angptl4 is a key fibrogenic molecule in progressive diabetic kidney disease[J]. Sci Adv, 2024,10 (49):eadn6068.
[19] BANO G, IMAM M T, BAJPAI R, et al. Expression of angiopoetin-like protein-4 and kidney injury molecule-1 as preliminary diagnostic markers for diabetes-related kidney disease: a single center-based cross-sectional study[J]. J Pers Med, 2023,13 (4):577.
[20] 耿辉,魏雁虹,杨广民. Cys C、NGAL联合Angptl4在诊断早期糖尿病肾病中的价值研究[J]. 中国医学创新,2022,19(6):11-15.
[21] TUTTLE K R, ALICIC R Z. Glycemic variability and KIM-1-induced inflammation in the diabetic kidney[J]. Diabetes, 2021,70 (8):1617-1619.
[22] BROOKS C R, YEUNG M Y, BROOKS Y S, et al. KIM-1-/TIM-1-mediated phagocytosis links ATG5-/ULK1-dependent clearance of apoptotic cells to antigen presentation[J]. EMBO J, 2015,34 (19):2441-2464.
[23] MORI Y, AJAY A K, CHANG J H, et al. KIM-1 mediates fatty acid uptake by renal tubular cells to promote progressive diabetic kidney disease[J]. Cell Metab, 2021,33 (5):1042-1061.
[24] VARATHARAJAN S, JAIN V, PYATI A K, et al. Neutrophil gela-tinase-associated lipocalin, kidney injury molecule-1, and perio-stin: novel urinary biomarkers in diabetic nephropathy[J]. World J Nephrol, 2024,13 (4):98880.

相似文献/References:

[1]温占兵,李真玉,刘 健,等.血管生成素-2与严重脓毒症肺毛细血管渗漏的相关性研究[J].天津医科大学学报,2013,19(06):474.
 WEN Zhan-bing,LI Zhen-yu,LIU Jian,et al.Correlation between Angiopoietin-2 and pulmonary capillary leak in severe septic patients[J].Journal of Tianjin Medical University,2013,19(02):474.

备注/Memo

备注/Memo:
基金项目 国家自然科学基金资助项目(82270856)
作者简介 王雅文(1993-),女,主管技师,硕士在读,研究方向:内分泌免疫学;通信作者:牛文彦,E-mail:wniu@tmu.edu.cn。
更新日期/Last Update: 2026-03-20