2型糖尿病患者血清胱抑素C水平与颈动脉内膜中层厚度的关系

Association between serum cystatin C and carotid intima - media thickness in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者血清胱抑素C（CystatinC）水平与颈动脉内膜中层厚度（CIMT）的关系。方法收集318例2型糖尿病患者的临床资料，所有纳入研究者均检测血清胱抑素C、血脂、血糖等血液生化指标以及颈动脉彩色超声检查。根据颈动脉彩色超声检查结果将患者分为两组：CIMT异常组（CIMT≥0．9mm，伴或不伴有颈动脉斑块形成）和CIMT正常组（CIMT〈0．9mm，且不伴有颈动脉粥样斑块形成）。用t检验分析两组患者血清胱抑素c等生化指标的差异，多因素Logistic回归分析CIMT增厚或斑块形成的相关因素。结果CIMT异常组的血清胱抑素c水平高于CIMT正常组[（1．24±0．22）mg／L比（1．05±0．41）mg／L，t=4．949，P〈0．001）]，多因素Logistic回归分析校正性别、年龄等因素后，血清胱抑素C与CIMT独立相关（OR=2．563，95％CI：1．026—6．403，P=0．044）。结论血清胱抑素C水平与CIMT密切相关。

Objective To evaluate the association between serum cystatin C and carotid atherosclerosis in patients with type 2 diabetes mellitus. Methods A total of 318 patients with type 2 diabetes mellitus were enrolled in this study. According to the results of carotid color Doppler ultrasound in the patients were randomly divided into two groups ：CIMT abnormal group （CIMT was equal to or larger than 0.9 ram,with or without associated with carotid artery plaque formation） CIMT and normal group （CIMT 〈 0.9 mm,and it was not associated with carotid artery atherosclerotic plaque formation. Differences in serum cystatin C, serum lipid and lipoprotein, fasting plasma glucose and other biochemical markers between the two groups were analyzed by using Student＇s t test. The correlated factors of the carotid thickness and plaque appearance were analyzed by Logistic regression analysis. Results The serum cystatin C levels of the CIMT abnormal group were higher than the normal CIMT group [ （ 1.24 ± 0.22） mg/L vs. （ 1.05± 0.41 ） rag/L, t = 4. 949, P 〈 0.001 ）. Multivariate logistic regression analysis showed adjusted for gender, age and other factors, serum cystatin C was independently associated factor of CIMT （ OR = 2. 563,95% CI： 1. 026 - 6. 403, P = 0. 044 ）. Conclusion Our data suggest that serum cystatin C is significantly associated with carotid atherosclerosis.