老年糖尿病肾病与血清胱抑素C、同型半胱氨酸、B型脑钠肽的关系

Association of the serum levels of Cystatin C,homocysteine,B-type natriuretic peptide etc. and diabetic nephropathy in aged type 2 diabetes

目的:探讨胱抑素C(CytC)、同型半胱氨酸(t-Hcy)、B型脑钠肽(BNP)、C反应蛋白(hs-CRP)、β2-微球蛋白(β2-MG)与老年2型糖尿病肾病(DN)的关系。方法:测定单纯2型糖尿病组(NDN)、糖尿病肾病组(DN)和对照组以及不同尿蛋白排泄率(UAER)组患者血清中CytC、t-Hcy、BNP、hs-CRP、β2-MG水平并收集其他危险因素资料。结果:DN组中Scr、UAER、CytC、t-Hcy、BNP、hs-CRP、β2-MG、SBP、LDL-C、2hPG水平显著高于单纯糖尿病组(NDN)和对照组。多元逐步回归分析表明β2-MG、CytC、hs-CRP、tHcy、BNP是影响UAER的重要因素。UAER、β2-MG、tHcy、CytC、hs-CRP、BNP等指标在DN早期肾病时即有明显变化,并且随着病情加重各因子水平不断升高。结论:血CytC、t-Hcy、BNP、hs-CRP、β2-MG是早期诊断老年DN和评价预后的敏感指标。

Objective To investigate the relationship between the serum Cystatin C(CytC),homocystein(t-Hcy),B-type natriuretic peptide(BNP),high sensitive C reaction protein(hs-CRP),β2-microglobulin(β2-MG)and diabetic nephropathy in aged type 2 diabetes.Methods The serum levels of CytC,t-Hcy,BNP,hs-CRP,β2-MG and other risk factors were measured in simple diabetic group(NDN),diabetic nephropathy group(DN),control subjects(NC) and various levels of urinary albumin excretion rate(UAER) groups in the elderly.Results(1)By group t-Test,the patients of DN group had longer courses and higher levels of Scr,UAER,β2-MG,t-Hcy,CytC,BNP,hs-CRP,SBP,LDL-C and 2hPG than NDN group and NC group(P<0.05).(2) Mutiple stepwise regression analysis results suggested that the serum levels of β2-MG,CytC,hs-CRP,tHcy,BNP play important roles in affecting UAER.(3)The levels of UAER、β2-MG、tHcy、CytC、hs-CRP、BNP were obviously varied in early stage of DN.With the increase of the levels of the factors,the pathogenetic condition in patients with DN became more and more serious.Conclusion Serum levels of CytC,BNP,β2-MG,hs-CRP and t-Hcy are sensitive indexes to early diagnose of DN in the aged and evaluation of Prognosis.