血清胱抑素C、视黄醇结合蛋白在早期2型糖尿病肾病中的应用价值

Application value of serum cystatin C and retinol binding protein in early type 2 diabetic nephropathy

目的探讨血清胱抑素C(CysC)、视黄醇结合蛋白(RBP)在早期2型糖尿病肾病中的诊断意义。方法选取我院2018年1月-2020年6月接诊的70例健康体检者作为正常对照组(NC),270例2型糖尿病患者作为研究对象,按24h尿蛋白/肌酐(UACR)分为单纯糖尿病组(SDM)、早期糖尿病肾病组(EDN)、临床糖尿病肾病组(CDN),均检测血清CysC、RBP、血肌酐(Cre),统计分析组间差异。结果SDM组与对照组相比,GLU、HbA1c水平升高显著,(P<0.05);EDN组CysC、RBP与对照组和SDM组比较水平升高显著(P<0.05);EDN组Cre、Glu、HbA1c水平仅较对照组升高显著(P<0.05);CDN组与NC组、SDM组、EDN组比较,CysC、RBP、Cre水平均显著依次升高(P<0.05),而Glu、HbA1c与SDM、EDN组无显著差异(P>0.05)。EDN、CDN组患者血清CysC、RBP阳性率明显高于NC组、SDM组(P<0.05)。血清CysC、RBP对EDN均有较好的灵敏度和特异度,在RBP诊断临界值为54.28mg/L时,对EDN诊断灵敏度为82.52%,特异度为86.28%。在CysC诊断临界值为1.05mg/L时,对EDN诊断灵敏度为80.25%,特异度为84.91%。结论血清CysC、RBP在糖尿病肾病患者中随着病情依次升高,EDN组患者血清CysC、RBP与其他组患者有显著差异,可作为2型糖尿病早期肾病的的预测指标。

Objective To investigate the diagnostic significance of serum cystatin C(CysC)and retinol binding protein(RBP)in early type 2 diabetic nephropathy.Methods Selected 70 healthy physical examination patients in our hospital from January 2018 to June 2020 as the normal control group(NC),and 270 patients with type 2 diabetes as the research object,according to the 24-hour urine protein/creatinine(UACR),divided into simple diabetes group(SDM),early diabetic nephropathy group(EDN),clinical diabetic nephropathy group(CDN).Serum CysC,RBP,and serum creatinine(Cre)were detected,and differences between groups were statistically analyzed.Results Compared with the control group,the levels of GLU and HbA1 cin the SDM group increased significantly(P<0.05);the levels of CysC and RBP in the EDN group increased significantly compared with the control group and the SDM group(P<0.05);the EDN group Cre,The levels of Glu and HbA1 cwere only significantly higher than those of the control group(P<0.05);compared with the NC group,SDM group,and EDN group,the levels of CysC,RBP,and Cre were significantly increased in the CDN group(P<0.05),while Glu.There was no significant difference between HbA1 cand SDM and EDN groups(P>0.05).The positive rates of serum CysC and RBP in EDN and CDN groups were significantly higher than those in NC and SDM groups(P<0.05).Serum CysC and RBP have good sensitivity and specificity to EDN.When the diagnostic cut-off value of RBP is 54.28 mg/L,the diagnostic sensitivity to EDN is 82.52%and the specificity is 86.28%.When the diagnostic cut-off value of CysC is 1.05 mg/L,the diagnostic sensitivity for EDN is 80.25%and the specificity is 84.91%.Conclusion Serum CysC and RBP in diabetic nephropathy patients increase with the condition.Serum CysC and RBP in EDN group are significantly different from those in other groups,which can be used as predictors of early type 2 diabetic nephropathy.