SOD、CysC和GHbA1c构成的联合因子对早期糖尿病肾病的诊断价值

Value of combined detection of serum superoxide dismutases,cystatin C and GHbA1c in the early diagnosis of diabetic nephropathy

目的探讨血清超氧化物歧化酶(SOD)、胱抑素C(CysC)和GHbA1c构成的联合因子在糖尿病肾病(DN)早期诊断中的价值。方法选择244例2型糖尿病患者,根据患者入院时的24 h尿白蛋白排泄率(UAER)分为糖尿病无肾病组(DN0组,100例)和早期DN组(DN1组,144例)。收集并比较2组的临床资料和血清学指标,分析早期DN的危险因素。绘制受试者工作特征(ROC)曲线并计算SOD、CysC和GHbA1c构成的联合因子诊断早期DN的曲线下面积。结果DN1组糖尿病病程、空腹血糖、GHbA1c、甘油三酯、HDL-C、UAER、血清尿酸、CysC水平高于DN0组,而SOD水平低于DN0组(P均<0.05)。Logistic回归分析显示,血清SOD水平是早期DN的保护因素(OR=0.873,P<0.001),而CysC(OR=15.921,P<0.05)和GHbA1(c OR=9.047,P<0.001)是早期DN的危险因素。SOD、CysC、GHbA1c构成的联合因子诊断早期DN的ROC曲线下面积为0.929(P<0.001)。结论血清SOD水平是早期DN的独立保护因素,可联合GHbA1c、CysC作为DN早期诊断的敏感指标。

Objective To evaluate the value of combined detection of serum superoxide dismutases(SOD),cystatin C(CysC)and GHbA1c in the early diagnosis of diabetic nephropathy(DN).Methods According to the 24-h urinary albumin excretion rate(UAER),244 patients with type 2 diabetes mellitus were divided into the DN0 group(n=100,no diabetic nephropathy),and DN1 group(n=144,early diabetic nephropathy).Clinical data and serological indexes in both groups were collected and compared to analyze the risk factors of early DN.The receiver operating characteristic(ROC)curve was drawn and the area under the ROC curve(AUC)for the combined detection of SOD,CysC and GHbA1c was calculated.Results In the DN1 group,the SOD level was significantly lower,whereas the course of type 2 diabetes mellitus,fasting blood glucose,GHbA1c,triglyceride,HDL-C,UAER,serum uric acid and CysC levels were significantly higher than those in the DN0 group(all P<0.05).Logistic regression analysis showed that serum SOD level was a protective factor for early DN(OR=0.873,P<0.001),while CysC(OR=15.921,P<0.05)and GHbA1c(OR=9.047,P<0.001)were the risk factors for early DN.The AUC of combined detection of SOD,CysC and GHbA1c was 0.929 in the diagnosis of early DN(P<0.001).Conclusions Serum SOD level is an independent protective factor for early DN.Combined detection of GHbA1c and CysC can act as a sensitive indicator for early diagnosis of DN.