Cys-C、NGAL及KIM-1对妊娠期糖尿病早期肾损伤的诊断价值

Clinical value of Cys - C, NGAL and KIM - 1 in diagnosis of early renal injury in patients with gestational diabetes mellitus

目的探讨血清胱抑素-C（Cys-C）、尿中性粒细胞明胶酶相关载脂蛋白（NGAL）与尿肾损伤分子-1（KIM-1）对妊娠期糖尿病（GDM）患者早期肾损伤的诊断价值。方法将90例所选对象分为GDM纽（60例）与正常妊娠组（30例），另选取30例体检非妊娠同龄女性作为对照组，测定并比较GDM组与正常妊娠组血清Cys-C、血清肌酐（cr）、血清尿素氮（BUN）、尿NGAL及尿KIM-1水平，计算GDM组各指标的受试者操作特征曲线（ROC曲线）面积。结果GDM组Cys-C[（1．25±0．18）mg／L]、NGAL[（124．57±23．66）ng／m1]、KIM-1[（534．47±103．57）ng／L]水平高于正常妊娠组[（0．87±0．12）mg／L、NGA（51．62±15．32）Ng／m2、KIM-1（107．23±22．89）Ng／L]，差异有统计学意义（P〈0．05）；GDM组Cr、BUN水平虽高于正常妊娠组，但两组比较差异未见统计学意义（P〉0．05）。Cys-C、Cr、BUN、NGAL、KIM-1的ROC曲线面积分别为0．93、0．81、0．82、0．95、0．94。结论GDM患者Cys-C、NGAL、KIM-1水平高于妊娠组和对照组，Cys-C、NGAL和KIM-1作为肾损伤标志物，对GDM具有早期诊断价值。

Objective To study the value of Cystatin - C （, Cys -C）, urine neutropnngelatinase associated lipocalin （NGAL） and urine kidney injury molecule 1 （ KIM - 1 ） in diagnosis of early renal injures of patients with gestational diabetes mellitus （GDM）. Methods Ninety patients were？ divided into GDM group （60 cases） and normal pregnancy group （30 cases） ; 30 cases of non -pregnant women of same peer were selected as control group. Levels of serum Cys - C, serum creatinine （ Cr）, blood urea nitrogen （BUN）, urine neutrophilgelatinase associated lipocalin （NGAL） and urine KIM -l were detec- ted and compared between GDM group and normal pregnancy group, areas under receiver - operating characteristic （ROC） curve of every indexes were calculated. Results The levels of Cys - C [ （ 1.25 ±0.20）mg/L], NGAL [ （ 124.57 ± 23.66） ng/ml] and KIM - 1 [ （536.38 ± 84.61 ） ng/L] in GDM group were higher than those in normal pregnancy group [ （0.71 ± 0.23 ）rag/L, （14.66 ± 5.79）ng/ml, （ 102.27 ± 34.01 ） ng/L], the differences were significant （ all P 〈 0.05）. Although the levels of Cr and BUN in GDM group were higher than those in normal pregnancy group, there was no significant difference between the two groups （P 〉 0.05）. Area under ROC curve of Cys - C, Cr, BUN, NGAL, KIM - 1 were 0.93, 0.81, 0.82, 0.95, 0.94 respectively. Conclusions The levels of Cys - C, NGAL and KIM - 1 in GDM group are higher than those in normal pregnancy group, which have early diagnostic val- ue for GDM as renal injury markers.