Diagnostic Value of Serum Lp-PLA2,NGAL and Urinary ACR Levels in Newly Diagnosed Type 2 Diabetes Patients for Early Renal Injury

SHI Linna; LU Yi; JIANG Yue; GONG Lihua; CHEN Yuli

doi:10.3969/j.issn.2095-3097.2024.06.016

Abstract：Objective To explore the diagnostic value of serum lipoprotein associated phospholipase A2 (Lp-PLA2),neutrophil gelatinase-associated lipocalin (NGAL) and albumin/creatinine ratio (ACR) levels in newly diagnosed type 2 dia-betes mellitus patients for early renal injury.Methods From September 2022 to September 2024,153 patients with T2DM complicated with renal injury and 153 patients with simple T2DM admitted to Nanjing Qixia district hospital were regarded as the study subjects,and were included in the T2DM+renal injury group and T2DM group,respectively.ELISA method was applied to detect the serum levels of Lp-PLA2 and NGAL in two groups.Immunoturbidimetry was applied to detect urinary protein in two groups.The colorimetric method was applied to detect the urinary creatinine level of two groups,and the ACR of the two groups were calculated.Pearson method was applied to analyze the correlation between Lp-PLA2,NGAL,ACR lev-els and clinical data.Multivariate logistic regression was applied to analyze the influencing factors of early renal injury in T2DM patients.ROC curve was applied to analyze the diagnostic value of Lp-PLA2,NGAL,and ACR levels for early renal injury in T2DM patients.Results Patients in the T2DM+renal injury group had significantly more years of disease duration,HbA1c,Scr,CysC,and BUN than those in the T2DM group,and eGFR was significantly lower than those in the T2DM group (P<0.05).The levels of serum Lp-PLA2,NGAL,and urinary ACR in the T2DM+renal injury group were obviously higher than those in the T2DM group (P<0.05).The levels of Lp-PLA2,NGAL,ACR were negatively correlated with eGFR level,and positively correlated with disease duration,HbA1c,Scr,CysC,and BUN levels (P<0.05).The OR of disease duration,HbA1c,Scr,CysC,BUN,Lp-PLA2,NGAL,and ACR were 2.248,2.649,3.125,3.638,2.657,3.642,4.237,and 4.516,were identified as risk factors for renal injury in T2DM patients,,and the OR of 0.422 for eGFR,serving as a protective factor for renal injury in T2DM patients (all P<0.05).The AUC of the combination of Lp-PLA2,NGAL,and ACR in the di-agnosis of early renal injury in T2DM patients was higher than that of Lp-PLA2 (Z=5.466,P<0.05),NGAL (Z=5.930,P<0.05),and ACR (Z=4.709,P<0.05) for single diagnosis.Conclusion SerumLp-PLA2,NGAL,and urinary ACR are upregulated in T2DM patients,and the combination of the three has high diagnostic value for early renal injury in T2DM.