胱抑素C在2型糖尿病患者早期肾病中的诊断价值

目的探讨胱抑素C(Cys-C)在2型糖尿病患者早期肾病中的诊断价值。方法纳入2016年6月至2017年12月我院内分泌科门诊收治及住院的2型糖尿病患者167例,根据美国肾脏病基金会的标准将患者分为A组85例,估算肾小球滤过率(eGFR)≥90 mL/(min·1.73 m~2)]和B组82例,eGFR 60~89 mL/(min·1.73 m~2)]。再纳入50名健康体检正常者为正常对照组(NC组)。测量所有受试者的身高、体重,并计算体重指数(BMI),检测总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血肌酐(Scr)、尿素氮(Urea)、尿酸(UA)、Cys-C、24 h尿白蛋白水平。比较三组的临床指标及肾功能指标,并分析eGFR与Cys-C、24 h尿白蛋白、Urea、UA的相关性。结果A、B组的Scr、Urea以及Cys-C水平均明显高于NC组,且B组明显高于A组(P<0.05)。A组与NC组的UA及24 h尿白蛋白水平无显著差异(P>0.05);B组的UA及24 h尿白蛋白水平显著高于NC组和A组(P<0.05)。Pearson线性相关性分析结果显示,eGFR与Cys-C、Urea呈显著负相关(r=-0.419、-0.435,P<0.001);与24 h尿白蛋白、UA无显著相关性(r=0.074、-0.082,P=0.288、0.347)。结论Cys-C较24 h尿白蛋白可以更早地发现糖尿病患者的早期肾功能损害,在糖尿病肾病的早期诊断中发挥重要的筛查作用。

Diagnostic value of cystatin C in early nephropathy of type 2 diabetes patients

Objective To explore the diagnostic value of cystatin C(Cys-C)in early nephropathy of type 2 diabetes patients.Methods A total of 167 patients with type 2 diabetes admitted and hospitalized in the endocrinology department of our hospital from June 2016 to December 2017 were included.According to the criteria of American kidney foundation,the patients were divided into group A85 cases,estimated glomerular filtration rate(eGFR)≥90 mL/(min·1.73 m~2)]and group B82 cases,eGFR 60-89 mL/(min·1.73 m~2)].Another 50 normal people who underwent physical examination were included as normal control group(NC group).The height and weight of all subjects were measured,and the body mass index(BMI)was calculated.The total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),serum creatinine(Scr),urea nitrogen(Urea),uric acid(UA),Cys-C,24 h urinary albumin level were measured.The clinical indexes and renal function indexes of the three groups were compared,and the correlation between eGFR and Cys-C,24 h urinary albumin,Urea,UA were analyzed.Results The levels of Scr,Urea and Cys-C of the group A and the group B were significantly higher than those of the NC group,and those in the group B were significantly higher than the group A(P<0.05).There were no significant differences in UA and 24 h urinary albumin levels between the group A and the NC group(P>0.05);UA and24 h urinary albumin levels of the group B were significantly higher than those of the NC group and the group A(P<0.05).Pearson linear correlation analysis results showed that eGFR were negatively correlated with Cys-C and Urea(r=-0.419,-0.435,P<0.001),and eGFR had no significant correlation with 24 h urinary albumin and UA(r=0.074,-0.082,P=0.288,0.347).Conclusion Cys-C can detect the early renal function damage of diabetic patients earlier than 24 h urinary albumin,which plays an important screening role in the early diagnosis of diabetic nephropathy.