糖尿病肾病早期诊断生物标志物的研究进展

Research Advances on Biomarkers for Early Diagnosis of Diabetic Nephropathy

摘要: 糖尿病肾病是糖尿病最常见的微血管并发症之一。目前已成为终末期肾脏病的首要病因，其在全球范围内的发病率及死亡率持续攀升，已构成重大公共卫生挑战。当前糖尿病肾病的诊断主要依据蛋白尿和微量白蛋白尿，然而这些指标缺乏足够的敏感性与特异性。肾穿刺活检虽为诊断金标准，但因具有出血、肾周血肿、动静脉瘘、感染和误伤周围脏器等一系列风险，在临床应用中受到限制。因此，开发无创、高特异性且适用于早期诊断的生物标志物及靶点已成为当前研究的重点。近年来，基于DN不同发病环节的生物标志物研究已取得一定进展，然而更多基于系统生物学方法的研究结果还有待进一步临床验证。

Abstract: Diabetic nephropathy (DN) is one of the most common microvascular complications of diabetes mellitus and has become the leading cause of end-stage renal disease worldwide. Its continuously rising global incidence and mortality rates pose a major public health challenge. Current diagnosis of DN primarily relies on proteinuria and microalbuminuria; however, these indicators lack sufficient sensitivity and specificity. Although renal biopsy remains the gold standard for diagnosis, its clinical application is limited due to its invasive nature and associated risks such as bleeding, perirenal hematoma, arteriovenous fistula, infection, and potential damage to adjacent organs. Consequently, the development of non-invasive, highly specific biomarkers and targets suitable for early diagnosis has become a key focus of current research. In recent years, studies on biomarkers involved in various pathological processes of DN have made significant progress, yet further clinical validation is still needed for many findings derived from systems biology approaches.