血清胱抑素C和同型半胱氨酸水平与早期糖尿病肾病的关系

Relationship of serum cystatin C and homocysteine levels with early diabetic nephropathy

目的探讨血清胱抑素C(Cys C)及同型半胱氨酸(Hcy)水平与早期糖尿病肾病的关系。方法选择我院肾脏风湿科2015年1月至2016年2月期间收治的121例2型糖尿病患者,将尿白蛋白排泄率(UAER)<30 mg/24 h者62例纳入单纯DM组,UAER在30~300 mg/24 h者59例纳入早期DN组,并选择50例健康体检者纳入对照组。检测并比较三组受检者的血肌酐(Scr)、尿素氮(BUN)、Cys C和Hcy水平。结果单纯DM组与对照组比较,UAER、血清Cys C、Hcy、Scr及BUN差异均无统计学意义(P>0.05);早期DN组UAER及血清Cys C、Hcy水平分别为(189.68±35.64)mg/24 h、(1.76±0.55)mg/L、(19.15±4.32)μmol/L,均明显高于单纯DM组的(14.58±4.68)mg/24 h、(0.57±0.32)mg/L、(13.62±3.52)μmol/L,差异均有统计学意义(P<0.05);早期DN组患者血清Cys C及Hcy阳性率分别为47.45%、50.85%,明显高于单纯DM组的19.35%、24.19%,差异均有统计学意义(P<0.05);Peason相关分析结果显示,血清Cys C、Hcy水平与UAER均呈正相关性(r=0.636、0.568,P<0.05)。结论 2型糖尿病患者定期检测血清Hcy、Cys C对早期识别及诊断糖尿病肾病具有重要意义。

Objective To investigate the relationship of serum cystatin C（Cys C） and homocysteine（Hcy） levels with early diabetic nephropathy. Methods A total of 121 type 2 diabetic patients, who admitted to Department of Renal and Rheumatism of our hospital from Jan. 2015 to Feb. 2016, were selected as the research objects. Among them,62 cases with urinary albumin excretion rate（UAER）30 mg/24 h were included into the simple DM group, and 59 cases with UAER for 30-300 mg/24 h were included into the early DN group. Fifty cases of healthy people were included into the control group. The serum creatinine（Scr）, urea nitrogen（BUN）, Cys C and Hcy levels of the three groups were detected and compared. Results There were no significant differences in UAER, Hcy, Cys C and Scr and BUN between the simple DM group and the control group（P〈0.05）. The UAER, serum Cys C and Hcy in the early DN group were（189.68±35.64） mg/24 h,（1.76±0.55） mg/L and（19.15±4.32） μmol/L, respectively, which were significantly higher than（14.58 ± 4.68） mg/24 h,（0.57 ± 0.32） mg/L,（13.62 ± 3.52） μ mol/L in the simple DM group（P〈0.05）. The positive rates of Cys C and Hcy in the early DN group were 47.45% and 50.85%, respectively, which were significantly higher than 19.35% and 24.19% in the DM group（P〈0.05）. Peason correlation analysis showed that serum Cys C, Hcy levels were positively correlated with UAER（r=0.636, 0.568, P〈0.05）. Conclusion The regular detection of serum Hcy and Cys C in patients with type 2 diabetes mellitus has important significance for early identification and diagnosis of diabetic nephropathy.