2型糖尿病肾病血清抗核抗体谱特征分析

Characterization of serum ANA profiles in type 2 diabetic nephropathy

摘要

目的：对血清抗核抗体（ANA）及其亚型抗体谱进行全面分析，旨在为2型糖尿病肾病（T2DN）血清ANA抗体精准检测提供指导。方法：采用回顾性队列研究设计，收集2016年1月至2025年6月在武汉大学中南医院和黄梅县人民医院就诊的1 334例2型糖尿病（T2D）和T2DN患者信息，间接免疫荧光法和免疫印迹法检测血清ANA及其亚型抗体。数据分析采用SPSS 27.0软件。结果：血清ANA阳性率和核型分布在两组之间差异没有统计学意义（P>0.05），ANA阳性率在T2D组为23.9%、T2DN组为25.1%，最常见的核型为核颗粒型和胞浆颗粒型；但ANA抗体滴度在两组之间差异有统计学意义，T2DN组高滴度ANA（1/640、1/1 280、1/2 560）占比更高（χ²=14.61，P<0.05）。此外，T2DN组抗Ro-52阳性率高于T2D组（χ²=4.96，P<0.05），但两组的阳性强度分布差异没有统计学意义（P>0.05）。结论：血清ANA检测有助于T2DN病人的精准诊疗，对现行的血清ANA-17种抗体套餐进行调整可提高T2DN病人就医的性价比。

Abstract

Objective: To provide evidence for cost-effective detection of serum antinuclear antibodies (ANA) in patients with type 2 diabetic nephropathy (T2DN) by analyzing the 17-panel of serum ANA and its subtypes. Methods: A total of 1 334 patients with type 2 diabetes (T2D) or T2DN were recruited from Zhongnan Hospital of Wuhan University and Huangmei People's Hospital from January 2016 to June 2025. Serum ANA and its subtypes were detected by indirect immunofluorescence and Western Blot. SPSS 27.0 software was used for data analysis. Results: There was no significant difference in the positive rate of serum ANA and its pattern distribution between the T2D group and T2DN group (P>0.05), with 23.9% T2D patients tested positive and 25.1% T2DN patients tested positive. The most common ANA patterns were nuclear speckled and cytoplasmic speckled. The proportion of high titer ANA (1/640, 1/1 280, 1/2 560) in T2DN group was higher than that in T2D group (χ ²=14.61, P<0.05). In addition, the positive rate of anti-Ro-52 in T2DN group was higher than that in T2D group (χ ²=4.96, P<0.05), but there was no significant difference in the fluorescence intensities between the two groups (P>0.05). Conclusion: Serum ANA detection is beneficial for the precise diagnosis and treatment of T2DN. Adjustment of the current serum ANA-17 antibody panel could be more cost-effective for detection of ANA in T2DN.

关键词

2型糖尿病 / 2型糖尿病肾病 / 抗核抗体

Key words

Type 2 Diabetes / Type 2 Diabetic Nephropathy / Antinuclear Antibody

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基金资助

国家自然科学基金青年基金项目(82202619)