血清脂蛋白(a)和胱抑素C与2型糖尿病及微血管并发症的临床研究

Clinical study of serum lipoprotein(a) and cystatin C with type 2 diabetes mellitus and microvascular complications

目的分析血清脂蛋白(a)[Lp(a)]和胱抑素C(Cys-C)在2型糖尿病(T2DM)以及微血管并发症患者中的变化,探讨其与T2DM及微血管并发症之间的关系。方法分别测定各组糖化血红蛋白(Hb A1c)、低密度脂蛋白(LDL)、尿素氮(BUN)、血肌酐(SCr)、Lp(a)和Cys-C水平,比较其与微血管并发症的关系。结果 T2DM患者的血清Lp(a)和Cys-C水平升高,差异有统计学意义(P<0.05)。与无微血管病变的T2DM组相比,DR组和DPN组血清Lp(a)水平升高,而DN组血清Lp(a)和Cys-C水平均升高,并且随着尿白蛋白排泄率(UAER)的升高,血清Lp(a)、Cys-C水平逐渐升高,差异均有统计学意义(P<0.05)。Logistic回归分析显示,高水平的Lp(a)是2型糖尿病患者发生糖尿病肾病的危险因素。结论血清Lp(a)和Cys-C与2型糖尿病及微血管并发症具有相关性,Lp(a)在糖尿病肾病的早期就发生改变,同时检测血清Lp(a)和Cys-C对糖尿病微血管病变的早期发现有重要意义。

Objective To analyze the levels of serum lipoprotein（ a） [Lp（ a） ]and cystatin C（ Cys-C） in type 2 diabetes mellitus（ T2DM） patients,and to determine the relationship between them and diabetic microvascular complications. Methods The levels of glycosylated hemoglobin（ Hb A1c）,low density lipoprotein（ LDL）,urea nitrogen（ BUN）,serum creatinine（ SCr）,Lp（ a） and Cys-C of each group were measured. The correlation between the biochemical indexes and the microvascular complications were assessed. Results The levels of Lp（ a） and Cys-C in T2 DM increased significantly,and the difference was statistically significant（ P 0. 05）. Compared with the T2 DM without complications,the levels of Lp（ a） in DR group and DPN group increased significantly,while the levels of Lp（ a） and Cys-C in DN group increased. With the increase of UAER in diabetic nephropathy,Lp（ a） and Cys-C levels increased,and the differences were statistically significant（ P 0. 05）. Logistic regression analysis showed that the high level of Lp（ a） was a risk for diabetic nephropathy in T2 DM. Conclusion The levels of Lp（ a） and Cys-C were correlated with T2 DM and microvascular complications,the level of Lp（ a） changed in the early stage of diabetic nephropathy,so the combined detection of serum Lp（ a） and Cys-C has great significance in the early diagnosis of microvascular complications in T2 DM.