血清胱抑素C水平与中老年人2型糖尿病合并脑梗死的相关性

Association between serum levels of serum cystatin-C cerebral infaration in elderly type 2 diabetes patients

目的探讨2型糖尿病合并脑梗死的中老年患者血清胱抑素-C(Cys-C)的变化及临床意义。方法选取中老年2型糖尿病患者126例,其中合并脑梗死的患者30例,单纯糖尿病患者96例,另选取健康对照者36例。测定所有受试者的空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(Hb A1C)、血清Cys-C、同型半胱氨酸(Hcy)、基质金属蛋白酶-9(MMP-9)的水平及颈动脉内膜中层厚度(CIMT)。结果 2型糖尿病合并脑梗死、单纯2型糖尿病受试者的FBG、TG、TC、LDL-C、HDL-C、Hb A1C、血清Cys-C、Hcy、MMP-9及CIMT与健康对照组比较,差异有显著统计学意义(P<0.01),且2型糖尿病合并脑梗死的各指标与单纯2型糖尿病比较,差异亦有统计学意义(P<0.05)。血清Cys-C水平与CIMT呈正相关。血清Cys-C可能是2型糖尿病合并脑梗死发病的独立预测因子。结论血清Cys-C可能是2型糖尿病合并脑梗死的独立预测因子,联合血清Cys-C、Hcy、MMP-9水平的测定对预测中老年人2型糖尿病合并脑梗死可能更有意义。

Objective To analyze serum levels of cystatin C in elderly type 2 diabetes patients with cerebral infaration and clinical significance. Methods One hundred and twenty six elderly diabetes patients were divided into DM group（n =96） and diabetes with cerebral infaration group（DCI,n = 30）.30 healthy subjects during the same period were selected as healthy control group. Their general clinical data were collected; their serum cystatin C, homocysteine and MMP-9 levels and their bilateral carotid intima media thickness（CIMT） were measured. Results The concentration of fasting blood sugar,total cholesterol,triaoylglycerol,low density lipoprotein cholesterol,Hb A1 C,high density lipoprotein cholesterol and the serum levels of cystatin C,homocysteine and MMP-9 and CIMT in DCI group and DM group were significantly higher than those in control group（P〈0.01）; these levels were higher for DCI group than DM group（P〈0.05）The concentration of high density lipoprotein cholesterol was markedly lower in control group（P〈0.01）, which was followed by DCI group（P〈0.05）. The cartid intima-media thickness（CIMT） was positively correlated with serum levels of cystatin-C. Conclusion The serum cystatin C level may be an independent risk factor for elderly type 2diabetes patients with cerebral infaration. A comprehensive understanding of serum levels of cystatin-C,homocysteine and MMP-9 in elderly type 2 diabetes patients can predict cerebral infaration.