Abstract：Objective: To explore the diagnostic significance of combined detection of neutrophil gelatinase-associated lipocalin (NGAL) in urine, serum pentraxin 3 (PTX3), and secreted frizzled-related protein 4 (SFRP4) in clinical diabetic nephropathy (DN). Methods: A total of 86 DN patients treated at our hospital from December 2020 to June 2023 were selected as the DN group. According to urinary albumin excretion rate (UAER), they were divided into the early group (24 cases, UAER ≤ 20 μg/min), the middle group (30 cases, 20 μg/min < UAER < 200 μg/min), and the late group (32 cases, UAER ≥ 200 μg/min). Based on the severity of the disease, they were further divided into mild DN group (40 cases) and moderate to severe DN group (46 cases). Additionally, 40 patients with type 2 diabetes without nephropathy were selected as the control group. Serum PTX3, SFRP4, and urinary NGAL levels were compared between the DN group and the control group, among different severity groups, and between early, middle, and late-stage groups. The clinical value of the three markers and their combined detection in diagnosing DN was analyzed. Results: Levels of serum PTX3, SFRP4, and urinary NGAL in the DN group were higher than those in the control group (P < 0.05). Patients in the moderate to severe DN group showed significantly elevated levels of all three markers compared to the mild DN group (P < 0.05). The levels of the three markers in the middle and late-stage DN groups were higher than those in the early-stage group (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) for the combined diagnosis of DN by the three markers was 0.985, and the AUC for the combined diagnosis was higher than that for individual markers (Z combined-PTX3=2.670, Z combined-SFRP4=3.976, Z combined-NGAL=2.510, P=0.008, 0.000, 0.012). The sensitivity was 94.20%, and the specificity was 96.00%. Conclusion: Combined detection of serum PTX3, SFRP4, and urinary NGAL has higher reliability in diagnosing DN and assessing the severity of DN patients.
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2024, Vol. 30 
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