关键词: 腹腔脂肪型丝氨酸蛋白酶抑制剂, 抗菌肽, 糖尿病患儿, 肾功能

Abstract: Objective To explore the predictive value of the expression of serum abdominal fat Serpin (Vaspin) and Cathelicidin cathelicidin (LL-37) on the early changes of renal function in children with diabetes. Methods Eighty hospitalized children with diabetes admitted to the First People's Hospital of Zunyi City from July 2020 to July 2023 were selected as the study subjects. They were divided into normal group (urinary protein<30 g/g Cr, n=31), micro group (urinary protein 30~300 g/g Cr, n=24), and large group (urinary protein>300 g/g Cr, n=25) according to their urinary protein level. Compare the expression levels of serum Vaspin and cathelicin in three groups of children, compare the routine renal function injury indicators of uric acid (UA), urea nitrogen (BUN), blood creatinine (Scr), and cystatin C (CysC) in three groups of children, analyze the correlation between serum Vaspin and cathelicin with UA, BUN, Scr, and CysC levels, and establish a subject characteristic (ROC) working curve to analyze Vaspin The critical value and diagnostic efficacy of cathelicidin in the diagnosis of early renal function changes in children with diabetes. Results There were significant differences in the expression levels of Vaspin and cathelicin among the three groups of children. Vaspin levels in a large number of groups were significantly higher than those in the trace group and normal group, while cathelicin levels were significantly lower than those in the trace group and normal group (P<0.05); There were significant differences in the expression levels of UA, BUN, Scr, and CysC among the three groups of children. The levels of UA, BUN, Scr, and CysC in a large number of groups were significantly higher than those in the trace group and the normal group (P<0.05), but there was no significant difference between the trace group and the normal group (P>0.05); Spearman correlation analysis showed that UA, BUN, Scr, CysC were positively correlated with Vaspin, while UA, BUN, Scr, CysC were negatively correlated with cathelicin (P<0.05); When the critical value of Vaspin was 7.97 ng/mL, the diagnostic index reached the maximum value of 1.695, and the sensitivity and specificity of early renal function changes in children with diabetes were 85.37% and 82.73% respectively. The critical value of catalicidin is set to 22.14 μg/L, the diagnostic index reached the maximum value of 1.654, and the sensitivity and specificity of early renal function changes in children with diabetes were 84.84% and 80.73% respectively. When the critical value of Vaspin is 7.97 ng/mL and the critical value of catalicidin is 22.14 μg/L, the diagnostic index reached the maximum value of 1.731. The sensitivity of combined diagnosis of early renal function changes in children with diabetes was 93.15%, and the specificity was 88.34%, higher than that of single diagnosis. Conclusion Vaspin combined with cathelicidin can improve the diagnostic efficacy of early renal function changes in children with diabetes. For Vaspin>7.97 ng/mL, cathelicidin<22.14 μg/L and take relevant measures for intervention in a timely manner. However, since the levels of Vaspin and cathelicidin may be related to the damage of heart, blood vessels, gastrointestinal and other multiple organs caused by diabetes, whether Vaspin and cathelicidin can be used as independent predictors of early renal function changes in children with diabetes needs further research and analysis.

Key words: abdominal fat Serpin, cathelicidin, children with diabetes, renal function