血清胱抑素C在评估早期肾功能损害中的价值

The Clinical Significance of Serum Cystatin C in Early Renal Dysfunction of Patients with Gestational Diabetes Mellitus

目的:探讨血清胱抑素C(Cys-C)对妊娠期糖尿病(GDM)患者早期肾功能损害的评估价值。方法:在妊娠晚期,分别测量64例GDM患者(GDM组)和128例正常妊娠女性(对照组)的血清Cys-C、肌酐(Scr)和尿酸(UA)水平,GDM组同时检测24小时尿微量白蛋白定量和糖化血红蛋白(HbA1c)水平,根据HbA1c水平,32例HbA1c≥6.5%设为观察组1,32例HbA1c<6.5%设为观察组2,对各组观测数据进行统计学比较分析。结果:血清Cys-C水平在观察组1显著高于观察组2和对照组(P<0.05),观察组2显著高于对照组(P<0.05);血清UA和Scr水平观察组1显著高于观察组2和对照组(P<0.05);观察组2和对照组比较差异无统计学意义(P>0.05);相关分析显示,GDM组血清Cys-C水平与24小时尿微量白蛋白定量和HbA1c均存在显著正相关关系(r=0.814,r=0.947,P<0.01)。结论:血清Cys-C水平可以作为一项反映GDM患者早期肾功能变化情况的重要指标。

Objective：To evaluate the clinical significance of the serum cystatin C （Cys-C）in early renal dysfunction of patients with gestional diabetes mellitus （GDM）. Methods： Serum concentrations of Cys-C, creatinine（Scr） and Uric acid （UA）were measured in 64 patients with gestional diabetes mellitus （GDM group） and 128 normal pregnant women （ control group）. The 24-hour urinary protein quantification and HbA1 c levels were also detected in the GDM group. According to HbA1 c level ,32 cases with HbA1 c≥6.5% were assigned into group 1, and 32 cases with HbA1 c 〈 6.5% into group. Results： Serum Cys-C level in group 1 was significantly higher than those in group 2 and control group（ P 〈0.05） ,and that in group 2 was significantly higher than that in control group（ P 〈0.05）. Serum UA and Scr levels in group 1 were both sig- nificantly higher than those in group 2 and control group（ P〈0. 05）. Serum UA and Scr levels in group 2 and control group had no significant difference （ P 〉 0. 05）. Correlation analysis showed that significant positive correlations could be found between serum Cys-C level and 24-hour urinary protein quantification and HbA1 c in GDM patients（ r=0. 814, r=0. 947, P 〈0.01 ）. Conclusions： Serum Cys-C may work as a potential pre- dictive marker to the early renal function in patients with gestional diabetes mellitus.