Diagnostic Value of Serum S1P, sICAM-1, and Urinary mAlb in Diabetic Nephropathy and Their Correlation with Disease Severity

doi:10.16458/j.cnki.1007-0893.2025.11.017

Abstract：Objective: To investigate the diagnostic value of serum sphingosine-1-phosphate (S1P), soluble intercellular adhesion molecule-1 (sICAM-1), and urinary microalbumin (mAlb) levels in diabetic nephropathy and their correlation with disease severity. Methods: A total of 70 patients with diabetic nephropathy (diabetic nephropathy group), 70 patients with diabetes without renal dysfunction (diabetes group), and 70 healthy volunteers (control group) were selected from the Second Affiliated Hospital of Nanyang Medical College from March 2021 to March 2024. Serum S1P, sICAM-1, and urinary mAlb levels were detected and compared among the three groups. The diagnostic value was evaluated, and receiver operating characteristic (ROC) curves were drawn. Further, the diabetic nephropathy group was divided into stages (I–V), and the correlation between the above indicators and disease severity was analyzed. Results: Serum S1P, sICAM-1, and urinary mAlb levels in patients with diabetic nephropathy were higher than those in the diabetes group and control group, with statistically significant differences (P < 0.05). Logistic regression analysis showed that elevated serum S1P, sICAM-1, and urinary mAlb levels were independent risk factors for the occurrence of diabetic nephropathy, with statistically significant differences (P < 0.05). The combined detection of S1P, sICAM-1, and mAlb achieved a diagnostic sensitivity and specificity of 93.54% and 85.45%, respectively, with an area under the ROC curve (AUC) of 0.897, which was higher than that of any single indicator alone. Comparisons of S1P, sICAM-1, and mAlb levels among patients with different stages of diabetic nephropathy showed statistically significant differences (F = 76.857, 125.742, 69.478, P < 0.05). Spearman correlation analysis showed that serum S1P, sICAM-1, and urinary mAlb levels were positively correlated with the severity of diabetic nephropathy, with statistically significant differences (P < 0.05). Conclusion: Combined detection of serum S1P, sICAM-1, and urinary mAlb has high diagnostic value for diabetic nephropathy and is positively correlated with disease severity, making it a potential auxiliary diagnostic and predictive indicator for early detection.