胱抑素C在2型糖尿病肾病患者早期的检测及意义

Significance of cystatin C in type 2 diabetic nephropathy patients

目的:血清和尿液探索胱抑素C在预测2型糖尿病肾病患者蛋白正常时肾功能损害的临床意义,评价其与蛋白尿的关系。方法:将232例患者分成3组:正常蛋白尿组、微量白蛋白尿组和大量白蛋白尿组,检测肌酐、尿白蛋白、血清/尿胱抑素C、肾小球滤过率(eGFR、MDRD计算的eGFR和CKD-EPI计算的eGFR)。结果:胱抑素C随尿蛋白的增加而增加。血清胱抑素C受CRP、性别、尿白蛋白/肌酐比值和eGFR影响,而尿胱抑素C受甘油三酯、年龄、eGFR和ACR影响。胱抑素C在正常蛋白尿组MDRD计算的eGFR<60 ml/min/1.73 m2中是独立因子。结论:胱抑素C在诊断2型糖尿病肾病尿蛋白正常时为有用的指标。

Objective：To evaluate clinical usefulness of cystatin C levels in serum and urine in predicting renal impairment in normoalbuminuric patients with type 2 diabetes and to evaluate the association between albuminuria and serum/urine cystatin C. Methods： 232 type 2 diabetic patients with normoalbuminuria, microalbuminuria and macroalbuminuria were enrolled. Creatinine, urinary albumin levels, serum/urine cystatin C and estimated glomeru- lar filtration rate （ eGFR by MDRD and CKD - EPIequations） were determined. Results ： The cystatin C levels of serum and urine increased with increasing degree of albuminuria. Serum cystatin C was affected by C - reactive protein （CRP）, sex, albumin -creatinine ratio （ACR） and eGFR. Urine eystatin C was affected by triglyeeride, age, eGFR and ACR. Cystatin C levels of serum and urine were identified as independent factors associated with eGFR 〈 60 ml/min/1.73 m^2 estimated by MDRD equation in patients with normoalbuminuria. Conclusion： The cystatin C levels could be useful markers for renal dysfunction in type 2 diabetic patients with normoalbuminuria.