血FFA、Hcy和Cys-C测定在糖尿病肾病早期诊断中的应用价值

Application value of serum FFA, Hcy and Cys-C levels in diagnosing diabetic nephropathy at early stage

目的研究游离脂肪酸(FFA)、同型半胱氨酸(Hcy)、胱抑素C(Cys-C)等指标血清水平与2型糖尿病(T2DM)各阶段的关系以及应用价值。方法选择T2DM患者150例,根据24 h尿微量白蛋白排泄率(UAER)分为单纯糖尿病组(SDM组)54例、早期糖尿病肾病期组(EDN组)56例和临床糖尿病肾病期组(CDN组)40例,同时选择同期进行健康体检确定为健康者42例作为对照组。所有研究对象均测定血清中FFA、Hcy、Cys-C等指标含量,采用方差分析和应用Pearson相关性分析对各指标进行统计学分析。结果 CDN组、EDN组血清中FFA、Hcy、Cys C水平均高于SDM组和对照组(P<0.05),且血清中FFA、Hcy、Cys C水平CDN组>EDN组>SDM组>对照组,各组间比较差异均具有统计学意义(P<0.05);T2DM患者血清FFA、Hcy、Cys C水平与UAER呈正相关(r=0.718,0.417,0.361;P<0.05)。结论糖尿病患者FFA、Hcy、Cys C水平与糖尿病肾病的发展进程有关,各项指标的联合检测对早期诊断糖尿病肾病有重要的临床应用价值。

Objective To establish the relationship between indexes of serum free fatty acids（FFA）, homocysteine（Hcy） and Cystatin-C（Cys-C） levels with Type 2 diabetes mellitus（T2DM） at each stage, and to determine their application values. Methods One hundred and fifty T2 DM patients were selected and divided into three groups according to the levels of urinary albumin excretion rates（UAER）： simple diabetic mellitus group（SDM group, n=54）, early diabetic nephropathy group（EDN group, n=56）, clinical diabetes nephropathy group（CDN group, n=40）.Forty-two healthy subjects of the same period determined by physical examination were enrolled as the control group.FFA, Hcy and Cys-C and other indexes in serum were determined for all subjects. T-test and variance analysis and Pearson correlation analysis were applied to make statistical analysis of all indexes. Results Serum FFA, Hcy, Cys C levels in CDN group and EDN group were significantly higher than SDM group and the control group（P〈0.05）, and the levels from high to low was CDN group, EDN group, SDM group, the control group, with statistically significant difference between any two groups（P〈0.05）. In T2 DM patients, the FFA, Hcy, Cys C levels were found positively correlated with UAER（r=0.718, 0.417, 0.361; P〈0.05）. Conclusion The FFA, Hcy and Cys C levels of T2 DM patients are related with the development process of diabetic nephropathy. Joint detection of all indexes has significant clinical application value in the early diagnosis of diabetic nephropathy.