胱抑素C水平与2型糖尿病肾病的相关性研究

Cystatin C level and diabetic nephropathy in type 2 diabetes mellitus

目的:探讨2型糖尿病患者血清胱抑素C水平与糖尿病肾病及血脂代谢之间的相关性。方法:回顾分析2016年1月~2017年6月弋矶山医院收治住院的192例2型糖尿病(T2DM)患者的临床资料,根据24 h尿白蛋白排泄率(UAER)分3组,即正常尿蛋白组62例,微量尿蛋白组65例,临床尿蛋白组65例;检测患者空腹血糖(FBG)、尿素氮(BUN)、肌酐(SCr)、胱抑素C(CysC)、血脂及UAER水平,运用统计学分析CysC在T2DM患者肾功能损害中的变化。结果:临床尿蛋白组、微量尿蛋白组CysC水平均高于正常尿蛋白组(P<0.05)。根据CysC又将192例T2DM患者分为两组,CysC≥1.25 mmol/L为升高组,CysC<1.25 mmol/L为正常组,CysC升高组中120例总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)高于CysC正常组(P<0.05)。结论:CysC水平与血脂紊乱有相关性,CysC检测有助于T2DM肾病的早期诊断。

Objective:To investigate the relationship between cystatin C(CysC)level and diabetic nephropathy in type 2 diabetes mellitus(T2DM).Methods:The clinical data were retrospectively analyzed in 192 cases of T2DM treated in our hospital between January 2016 and June 2017.All cases were divided three groups by the 24 hour urinary albumin excretion rate(UAER),namely:normal urinary protein group(n=62),trace urinary protein group(n=65)and clinical urine protein group(n=65).Laboratory studies included fasting blood glucose(FBG),blood urea nitrogen(BUN),serum creatinine(SCr),cystatin C(CysC),serum lipid and AER levels.Statistical analysis was performed for CysC changes and progression of diabetic nephropathy in T2DM patients.Results:Patients in the clinical urine protein group and trace urinary protein group had higher CysC level than those in normal urinary protein group(P<0.05).After subgrouping the 192 T2DM patients by CysC level into rising group(CysC≥1.25 mmol/L)and normal group(Cys C<1.25 mmol/L),patients in the rising group had higher TC,TG and LDL levels(P<0.05).Conclusion:Measurement of CysC level may contribute to early diagnosis of diabetic nephropathy in T2DM patients,and CysC level is associated with lipid metabolism.