Diagnostic value of serum amyloid A and retinol binding protein in patients with early type 2 diabetic kidney disease

Abstract

Objective To investigate the value of serum amyloid A (SAA) and retinol binding protein (RBP) in diagnosis of early type 2 diabetic kidney disease (DKD). Methods A total of 182 type 2 diabetic patients hospitalized in department of Endocrinology and Nephrology of Lianyungang Second People′s Hospital from January to December 2017 were randomly collected as subjects.According to urinary albumin-creatinine ratio (UACR), all subjects were divided into three groups of normal albuminuria group (NA, 60 cases), microalbuminuria group (MA, 63 cases) and clinical proteinuria (CP, 59 cases). In the same period, 60 healthy persons were selected as normal control (NC). The levels of serum SAA and RBP were detected by automatic biochemical analyzer.Receiver operating curve (ROC) was used to analysis the diagnostic efficiency of DKD and the risk factors of DKD were further estimated. Results The levels of SAA were (6.88±2.82) and (37.21±20.58) mg/L in control group and case group.And levels of serum SAA in the NA group, MA group and CP group were (16.33±5.98), (40.97±15.62), (54.43±22.91) mg/L respectively.The levels of RBP were (37.56±10.51) and (69.26±21.23) mg/L in control group and case group.And levels of RBP in the NA group, MA group and CP group were (52.66±14.31), (69.66±15.52), (85.70±19.51) mg/L respectively.The concentrations of serum SAA and RBP in type 2 diabetic patients were significantly higher than those normal controls (t=10.36, P<0.05; t=11.11, P<0.05) and increased with DKD progression (F=83.6, P<0.05; F=59.2, P<0.05). Diagnostic sensitivity of serum SAA, RBP in DKD was 81.8% and 84.1% respectively.Diagnostic sensitivity of combined detection was 90.9%.Regression analysis showed that SAA, RBP and UACR were independent risk factors for DKD (OR(95%CI)=1.391(1.068-1.812), 1.212(1.085-1.353), 1.148(1.038-1.270); all P<0.05). Conclusion Both of serum SAA and RBP were significantly elevated in diabetic patients with renal injury so that they had great value in early diagnosis of DKD. Key words: Amyloid A; Retinol binding protein; Diabetic nephropathy; Urinary microalbumin; Urinary creatinine