Correlation Between Urinary Podocalyxin,Serum HMGA2,SDF-1 Levels and Tervaert Stage of Diabetic Nephropathy in Pathological Biopsy

YIN Hongmei; LIU Lijun; LI xin

doi:10.13730/j.issn.2097-2148.2025.11.004

Abstract：Objective To investigate the correlation between urinary podocalyxin,serum high mobility group pro-tein A2(HMGA2)and stromal-derived factor 1(SDF-1)levels and the Tervaert stage of diabetic nephropathy(DN)in pathological biopsy.Methods A total of 70 patients diagnosed with DN admitted to the author's hospital from May 2020 to January 2024 were selected as the DN group,and 70 patients with simple diabetes mellitus who were admitted during the same period were selected as the diabetes mellitus group.The clinical data of the two groups were collected.Urine and serum samples were collected in the fasting state at admission,and the levels of urinary podocalyxin,serum HMGA2 and SDF-1 were detected.Univariate and multivariate Logistic regression analysis were used to investigate the effect of urinary podocalyxin,serum HMGA2 and SDF-1 on the occurrence of DN.The receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of urinary podocalyxin,serum HMGA2 and SDF-1 in different Tervaert stages.Results The serum creatinine level in DN group was significantly higher than that in diabetes mellitus group(P＜0.05).The levels of urinary podocalyxin,serum HMGA2 and SDF-1 in DN group were higher than those in diabetes mellitus group(all P＜0.001);the levels of urinary podocalyxin,serum HMGA2 and SDF-1 in DN patients with differ-ent Tervaert stages were significantly different(all P＜0.001),with the increase of Tervaert stages,the levels of urinary podocalyxin,serum HMGA2 and SDF-1 in DN patients gradually increased,and the differences between two groups were statistically significant(all P＜0.05).Logistic regression analysis showed that urinary podocalyxin,serum HMGA2 and SDF-1 were risk factors for DN(all P＜0.05).Urinary podocalyxin,serum HMGA2 and SDF-1 had high diagnostic value in Tervaert staging.In grade Ⅰ,SDF-1 had the best performance with an area under the curve(AUC)of 0.993(95％CI:0.979-1.000);HMGA2 had the best AUC of 0.899(95％CI:0.799-0.999)in grade Ⅱ;HMGA2 had the best AUC of 0.809(95％CI:0.685-0.932)in grade Ⅲ;urinary podocalyxin in grade Ⅳ was the best,with an AUC of 0.899(95％CI:0.799-0.999).The sensitivity and specificity of each index were different with the change of stage,and the overall performance was good.Conclusion Urinary podocalyxin,serum HMGA2 and SDF-1 are abnormally expressed in DN patients,which are related to the Tervaert stage,and they can be used to predict the occurrence and development of DN.