胱抑素在糖尿病早期肾损伤检测中的价值评估

Evaluation of cystatin C for early detection of renal impairment in diabetes

目的评估胱抑素在糖尿病肾损伤早期检测中的应用价值。方法通过免疫比浊法检测血清胱抑素,碱性苦味酸速率法检测血清肌酐,并与肾病饮食调整公式校正的肾小球滤过率(GFR MDRD)比较,评估63例肌酐正常的糖尿病病人的早期肾损伤。结果血清胱抑素与肌酐之间呈正相关(r=0.55),与肾病饮食校正的肾小球滤过率呈负相关(r=0.48)。胱抑素的受试者工作曲线下面积(0.79)与似然比(4.3)分别高于肌酐的曲线下面积(0.60)与似然比(1.6)。结论在糖尿病早期肾损伤的检测中,血清胱抑素能较好地反映肾小球滤过率,其诊断效能优于血清肌酐。

Objective To evaluate cystatin C for early detection of renal impairment in diabetes. Methods The serum cystatin C was detected by immunonephelometric method. The creatinine was measured with a Jaffe rate method. 67 diabetic patients with normal creatinine were evaluated for their early renal impairment. Results Significant direct correlations were found between cystatin C and creatinine （r=0. 55）, and inverse correlations between cystatin C and glomerular filtration rate calculated with the MDRD equation （r= 0.48）. The area under the receiver operating characteristic curve （0. 79 ） and likelihood ratio （ 4.3） of cystatin C was better than the area （0. 60） and likelihood ratio （1.6） of ereatinine. Conclusion In early detection of diabetic renal injury, serum cystatin C can estimate glomerular filtration rate and present a better diagnostic efficiency than serum creatinine.