脏损伤尿液生物标志物儿童的正常范围
Hannah Weber1, Katharina Schermuly1, Anna Tschirner1
1Department of Pediatric Kidney, Liver, Metabolic and Neurological Diseases, Hannover Medical School, Hannover, Germany.
Kidney international reports
|March 11, 2026
概括
已经确定了KIM-1和NGAL等尿损伤生物标志物的新儿科参考值. 这些取决于年龄和性别的值改善了对儿童脏健康的解释.
科学领域:
- 儿科脏病学 儿科脏病学
- 生物标志物发现发现
- 临床化学 临床化学
背景情况:
- 传统的病生物标志物 (例如,eGFR,白蛋白尿) 在敏感性和特异性方面具有限制.
- 新的尿路生物标志物 (KIM-1,NGAL,DKK3,CHI3L1,MCP-1,PIIINP,EGF) 在检测成年人损伤方面表现有前途.
- 由于缺乏确定的儿科参考值,这些敏感的尿路生物标志物的临床使用在儿童中受到阻碍.
研究的目的:
- 为敏感的尿损伤生物标志物开发基于lambda-mu-sigma (LMS) 的连续儿科参考值.
- 为了确定儿童尿液KIM-1,NGAL,DKK3,CHI3L1,MCP-1,PIIINP和EGF的特定年龄和性别的参考范围.
- 为了促进对儿童群体脏生物标志物测试结果的标准化解释.
主要方法:
- 汉诺威儿科参考值研究 (HARP) 招募了304名年龄在0.1至18岁的儿童.
- 尿路生物标志物使用酶相关免疫吸收试验 (ELISA) 量化,并将其正常化为尿路肌.
- 基于LMS的连续参考百分位数是使用RefCurv软件生成的.
主要成果:
- 基于LMS的百分位被确定为尿路KIM-1,NGAL,DKK3,CHI3L1,MCP1,PIIINP和EGF与肌素的比率,所有这些都显示出年龄依赖.
- 尿中NGAL,DKK3和MCP-1与肌素的比率也与性别有关.
- 大多数尿路生物标志物与肌素的比率在婴儿期达到峰值,并在18岁时下降,NGAL在18岁时显示出二次峰值,特别是在女孩身上.
结论:
- 所有测量的脏健康的尿路生物标志物都表现出年龄依赖性,部分依赖性.
- 开发的基于LMS的连续儿科参考百分位使得标准化患者z-score计算成为可能.
- 这些参考值对于准确和可靠地解释儿童脏生物标志物测试结果至关重要.
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