胱抑素C在2型糖尿病不同肾损害期的变化

The change of serum cystatin C and its clinical significance in type 2 diabetic patients with different stage of renal impairment

目的探讨血清胱抑素C(Cys-C)在2型糖尿病不同肾损害期的变化,评价Cys-C在2型糖尿病肾病早期的诊断价值。方法用颗粒增强免疫比浊法检测135例2型糖尿病患者(其中合并糖尿病肾病不同损害期77例)血清Cys-C,同时检测尿微量白蛋白排泄率(UAER),血Alb、Cr、BUN,根据MDRD公式计算肾小球滤过率。结果2型糖尿病正常白蛋白尿组与2型糖尿病微量白蛋白尿组间Cys-C水平差异有统计学意义(P<0.05,);2型糖尿病微量白蛋白尿组与2型糖尿病大量白蛋白尿组间Cys-C水平差异有统计学意义(P<0.01)。结论血清Cys-C可作为辅助2型糖尿病肾病早期诊断的指标。

Objective To investigate the change of serum cystatin C （Cys C） in different stage of renal impairment in type 2 diabetic patients and evaluate the diagnostic value of serum Cys-C at early renal impairment in type 2 diabetes. Methods The level of serum cystatin C was detected by particle enhanced immunonephelometry in 137 patients with type 2 diabetes mellitus （including 78 eases of diabetic nephropathy）. Urinary albumin excretion rate （UAER）, serum albumin, creatinine, blood urea nitrogen （BUN） were detected at the same time, and then the glomerular filtration rate （GFR） were calculated by MDRD equation. Results There was significant difference in serum level of Cys C between normal albuminuria group and microalbuminuria group （P〈0.05）, and the latter was signifi eantly different from macro albuminuria group in serum level of Cys C （P〈0.01）. The serum cystatin C in both micro albuminuria group and macro-albuminuria group was significantly correlative to the glomerular filtration rate （P〈0.01）. Conclusion Serum cystatin C can be used as a marker in early renal impairment in type 2 diabetes mellitus.