2型糖尿病患者视网膜病变与血清胱抑素C关系分析

Relationship of serum cystatin C with diabetic retinopathy in type 2 diabetic patients

目的探讨2型糖尿病患者视网膜病变与血清胱抑素C(Cys C)的关系。方法选取182例住院2型糖尿病患者,根据彩色眼底照相结果分为3组:其中82例无视网膜病变(A组),54例伴非增殖性视网膜病变(B组),46例伴增殖性视网膜病变(C组),并选取50例健康体检者作为对照组(NC组)。测定各组Cys C、同型半胱氨酸(Hcy)、空腹血糖(FBG)、糖化血红蛋白(HbA1C)、血肌酐(Scr)、24h尿白蛋白排泄量(24h-UAE),分析糖尿病患者视网膜病变与Cys C水平的关系。结果B、C组Cys C及Hcy水平均明显高于A组及NC组,且C组明显高于B组(均P<0.05)。Cys C与Hcy(r=0.857,P<0.01)、Sc(r r=0.859,P<0.01)、24h-UAE(r=0.362,P<0.05)及患者年龄(r=0.168,P<0.05)均呈正相关,而与FBG、HbA1C等无相关性。logistic逐步回归分析表明Cys C与FBG、HbA1C均为糖尿病视网膜病变的独立危险因素(均P<0.01)。结论Cys C水平升高是2型糖尿病患者并发视网膜病变的重要危险因素,检测Cys C水平有利于早期诊断糖尿病视网膜病变。

Objective To investigate the relationship between diabetic retinopathy(DR)and serum cystatinC(Cys C)in type 2 diabetic patients.Methods One hundred and eighty two diabetic patients were enrolled in the study,including 82 patients without DR(group A),54 with simple DR(group B)and 46 with proliferative DR(group C).Meanwhile,50 healthy subjects served as normal controls(group NC).Fasting blood glucose(FBG),glycoslated hemoglobinA1C(HbA1C),CysC,plasma homocysteine(Hcy),serum creatinine(Scr),24 hour urinary albumin excretion(24h-UAE)were tested,and relationship between DR and Cys C was analyzed.Results The CysC and Hcy levels in groups B,C were significantly higher than those of groups A and NC(P<0.05);the CysC and Hcy levels in group C were significantly higher than those in group B(P<0.05).Cys C was positively correlated with Hcy(r=0.857,P<0.01),Scr(r=0.859,P<0.01),24h-UAE(r=0.362,P<0.05)and age(r=0.168,P<0.05),but not with FBG and HbA1c.Multivariate logistic regression showed that Cys C,FBG and HbA1c were independent risk factors for diabetic retinopathy(P<0.05).Conclusion The level of CysC is an important risk factor for DR in type 2 diabetic patients.The detection of CysC may be beneficial to the early diagnosis of DR in type 2 diabetic patients.