The correlation between serum vitamin D binding protein and chronic kidney disease
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摘要:
目的：探讨血清维生素D结合蛋白（vitamin D binding protein，DBP）水平与慢性肾脏病（chronic kidney disease，CKD）发生的相关性。进一步建立CKD的临床风险预测模型，并评估其对CKD的预测效能。方法：选取2020年3—9月肾内科住院的患者，酶联免疫吸附法检测患者血清DBP水平，分析血清DBP与CKD相关指标的关系，比较高DBP组和低DBP组患者的临床资料。构建包含DBP的临床风险预测模型并评估其预测CKD发生的效能。结果：与正常对照组和CKD 3期患者相比，CKD 4期和CKD 5期患者血清DBP水平显著降低。血清DBP与CKD相关临床指标及干预措施具有明显的相关性。与综合临床风险预测模型A（年龄、性别、尿酸、是否合并瓣膜钙化、高血压、糖尿病）［受试者工作特征曲线的曲线下面积（area under curve，AUC）= 0.917，95% CI：0.849~0.985，P＜0.001］相比，综合临床风险预测模型B（年龄、性别、尿酸、DBP、是否合并瓣膜钙化、高血压、糖尿病）（AUC=0.942，95% CI：0.894~0.991，P＜0.001）增加了血清DBP这一预测变量，显著改善了预测CKD的受试者工作特征曲线的AUC和特异度。结论：血清DBP水平与CKD的发生具有相关性。增加血清DBP这一预测变量，可显著改善模型预测CKD的效能，有助于筛查CKD的高危患者。
Abstract:
Objective：This study aims to explore the relationship between serum vitamin D binding protein（DBP） level and the occurrence of chronic kidney disease （CKD），further establish a clinical risk prediction model for CKD and evaluate its predictive power for CKD. Methods：The patients who were hospitalized in the department of nephrology between March 2020 and September 2020 were selected. The serum DBP levels of the patients were detected by the ELISA method. The relationship between serum DBP and CKD related indicators was anacyzed. And the clinical data of the high DBP group and low DBP group were compared. A clinical risk prediction model including DBP was construct and its effectiveness was evaluated in predicting the occurrence of CKD. Results：Compared with the normal control group and CKD stage 3 patients，the serum DBP levels of patients with CKD stage 4 and CKD stage 5 were significantly lower. Serum DBP and CKD related indicators and interventions have obvious correlation. Compared with the comprehensive clinical risk prediction model A（AUC=0.917，95% CI：0.849~0.985，P＜0.001），the comprehensive clinical risk prediction model B（AUC=0.942，95% CI：0.894~0.991，P＜0.001） increased the serum DBP as a predictor variable，and significantly improved the AUC and，specificity for predicting CKD. Conclusion：Serum DBP decreases significantly in CKD 4-5 stages，which are correlated with the occurrence of CKD. The addition of the predictive variable of serum DBP significantly improves the predictive performance of the model in predicting CKD and helps to screen high-risk patients with CKD.
