2型糖尿病大血管病变与血清胱抑素C及超氧化物歧化酶的相关性研究

目的：探讨2型糖尿病(T2DM)大血管病变患者联合检测血清胱抑素C (Cys-C)与超氧化物歧化酶(SOD)的临床价值。方法将2014年1月至2015年12月在我院内分泌科住院的947例T2DM患者分为单纯T2DM组434例和合并大血管病变T2DM+MVC组513例，另选取健康体检者400例作为正常对照组，收集各组受检者的Cys-C、SOD等生化指标，分析Cys-C及SOD与T2DM大血管病变的相关性。结果 T2DM组及T2DM+MVC组患者的体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、Cys-C、血清肌酐(Scr)、血清尿酸(SUA)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、低密度脂蛋白(LDL-C)、甘油三酯(TG)、胆固醇(TC)均高于对照组，SOD、估算肾小球滤过率(eGFR)、高密度脂蛋白（HDL-C）均低于对照组，差异均有统计学意义(P<0.05)；T2DM+MVC组患者的病程、BMI、SBP、射血分数(EF)、Cys-C、Scr、SUA、HbA1c、eGFR、TG、TC均高于T2DM组，SOD、HDL-C均低于T2DM组，差异均有统计学意义(P<0.05)；T2DM患者的大血管病变与病程、SUA、Cys-C呈正相关(r=-2.954、1.241、4.225，P<0.05)，与SOD、eGFR呈负相关(r=-3.145、-2.524，P<0.05)，Cys-C与SOD呈负相关(r=-2.424，P<0.05)；联合检测Cys-C与SOD对T2DM+MVC诊断的价值：即Cys-C>1.35 mg/L且SOD<126 U/mL时，其敏感性为85.6%，特异性为89.2%。结论血清Cys-C及SOD水平与T2DM大血管病变的进程紧密相关，两者联合检测对于该病变的诊断有重要意义，同时为该疾病的治疗提供一定的指导价值。

Study on the correlation between macrovascular complications and superoxide dismutase,serum cystatin-C in type 2 diabetes mellitus

Objective To study the clinical value of combined detection of serum cystatin-C (Cys-C) and su-peroxide dismutase (SOD) in type 2 diabetes mellitus (T2DM) patients with macrovascular complications. Methods A total of 947 cases of T2DM patients in our hospital during January 2014 to December 2015 were divided into two groups: T2DM without complications (T2DM group, n=434) and T2DM with macrovascular complications group (T2DM+MVC group, n=513). Another 400 healthy subjects were selected as normal control group. The biochemical in-dexes of the serum Cys-C, SOD were collected, and the correlations between Cys-C, SOD and T2DM with macrovascu-lar complications were analyzed. Results The levels of body mass index (BMI), systolic blood pressure (SBP), diastol-ic blood pressure (DBP), Cys-C, serum creatinine (Scr), serum uric acid (SUA), fasting blood-glucose (FBG), hemoglo-bin A1c (HbA1c), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and total cholesterol (TC) in T2DM group and T2DM+MVC group were significantly higher than those in normal control group, and the SOD, estimated glo-merular filtration rate (eGFR), high density lipoprotein cholesterol (HDL-C) were significantly lower than those in nor-mal control group, with statistically significant differences (P<0.05). The levels of duration, BMI, SBP, ejection fraction (EF), Cys-C, Scr, SUA, HbA1c, eGFR, TG and TC in T2DM+MVC group were significantly higher than those in T2DM group, and the SOD, HDL-C were significantly lower than those in T2DM group, with statistically significant differenc-es (P<0.05). Diabetic macrovascular complications were positively correlated with duration, serum SUA and Cys-C (r=-2.954, 1.241, 4.225, P<0.05), which were negatively correlated with SOD and eGFR (r=-3.145,-2.524, P<0.05). The level of Cys-C was positively correlated with SOD (r=-2.424, P<0.05). For combined detection of Cys-C and SOD in the diagnosis of T2DM with macrovascular complications, the sensitivity and the specificity was 85.6%and 89.2%, re-spectively at Cys-C>1.35 mg/L and SOD<126 U/mL. Conclusion Serum Cys-C and SOD levels were closely related to the macrovascular complications progression of T2DM, and the combined detection of both of them had important sig-nificance in the diagnosis of the disease. It can provide some guidance value for the treatment of the disease.