高尿酸血症患者血清胱抑素C与肾小球滤过率的相关性研究

Relationship between serum cystatin C and eGFR in hyperuricemia patients

目的通过检测高尿酸血症(HUA)患者血清胱抑素-C(Cys-C)水平与GFR的相关性,探讨其在HUA性肾损伤早期诊断中的价值。方法 选取无症状HUA患者(sHUA)60例、痛风(Gout)患者50例和正常对照组(NC)60名。改良MDRD公式计算eGFR,并测定各组血清Cys-C、β2微球蛋白(β2-MG)、Scr、SUA、TG、高敏C反应蛋白(hsC-RP)等生化指标。分析血清Cys-C、β2-MG与eGFR、Scr等指标的关系。结果 Gout组血清Cys-C、β2-MG、Scr、SUA、hsC-RP、TG、BMI高于NC组(P<0.05或P<0.01),eGFR、HDL-C低于NC组(P<0.05),Cys-C、hsC-RP、BMI、β_2-MG高于sHUA组(P<0.05)。sHUA组Cys-C、SUA、TG高于NC组,HDL-C低于NC组。血清Cys-C与eGFR呈负相关(r=-0.457,P=0.003),与Scr、年龄、SUA呈正相关(r=0.472、0.325、0.171,P=0.000、0.001、0.05)。多元线性回归分析显示,eGFR、Scr、SUA、年龄是血清Cys-C水平升高的危险因素。结论血清Cys-C能反映GFR的变化,是HUA性肾损伤早期诊断的良好血清标志物。

Objective To evaluate the relationship between serum Cys‐C and GFR in hyperuricemic patients ,and to investigate the diagnostic value of serum Cys‐C in patients with hyperuricemic renal injury.Methods A total of 170 subjects were enrolled in this study ,and divided into three groups ：patients with asymptomatic hyperuricemia（sHUA group ,n=60） ,gout patients（Gout group ,n=50）and healthy controls （NC group ,n= 60）.eGFR were calculated by improved MDRD formula ,and serum Cys‐C ,β2‐MG ,Scr , hsC‐RP ,SUA ,TG were detected in all patients. The relationship between serum Cys‐C ,β2‐MG and eGFR , Scr were analyzed among the three groups. Results The Cys‐C ,β2‐MG ,Scr ,SUA ,hsC‐RP ,TG ,BMI in gout group were higher ,GFR and HDL‐C were lower ,than those in NC group（P〈0.05）;Cys‐C ,hsC‐RP ,BMI andβ2‐MG in gout group were higher than those in sHUA group（P〈0 .05）;Cys‐C ,SUA ,TG ,in sHUA group were higher ,HDL‐C were lower ,than those in NC group（P〈0 .05） .The correlation analysis showed that serum Cys‐C was negatively correlated with GFR （r= -0.457 ,P= 0.003） ,was positively correlated with Scr ,age ,SUA （r= 0.472 ,0.325 ,0.171 ;P= 0.000 ,0.001 ,0.05） .Multivariate linear regression analysis showed that the GFR ,Scr SUA and ,age are risk factors for elevated levels of serum Cys‐C . Conclusion Serum Cys‐C can be used as a new good marker for early hyperuricemic renal injury .