血清胱抑素C、补体C1q、成纤维细胞生长因子21、生长分化因子15与糖尿病肾病严重程度的相关性

Correlation between Serum Cystatin C,Complement C1q,Fibroblast Growth Factor 21,Growth Differentiation Factor 15 and the Severity of Diabetic Nephropathy

目的:探讨血清胱抑素C(CysC)、补体C1q、成纤维细胞生长因子21(FGF21)、生长分化因子15(GDF15)与糖尿病肾病(DN)严重程度的相关性。方法:回顾性分析2019年5月-2021年5月浏阳市人民医院永安分院收治的150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),将其分为早期糖尿病肾病(EDKD)组(56例)、临床糖尿病肾病(CDN)组(49例)及单纯2型糖尿病(T2DM)组(45例),另选取35例体检健康者纳入对照组。分别采集各组血清样本,检测并比较各组CysC、补体C1q、FGF21、GDF15、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、血尿素氮(BUN)及尿酸(UA)水平及胰岛素抵抗指数(HOMA-IR)。结果:单纯T2DM组、EDKD组及CDN组的CysC、补体C1q、FGF21及GDF15水平、HbA1c、FINS、BUN、UA水平及HOMA-IR明显高于对照组(P<0.001);EDKD组及CDN组的CysC、补体C1q、FGF21及GDF15水平、HbA1c、FINS、BUN、UA水平及HOMA-IR明显高于单纯T2DM组(P<0.001);CDN组的CysC、补体C1q、FGF21及GDF15水平、HbA1c、FINS、BUN、UA水平及HOMA-IR明显高于EDKD组(P<0.001)。Pearson相关性分析显示,CysC、补体C1q、FGF21及GDF15与早期DN患者HbA1c、FINS、BUN、UA、HOMA-IR及UAER均呈正相关(P<0.05)。结论:DN患者血清中CysC、补体C1q、FGF21及GDF15表达水平较高,且其与DN患者病情严重程度有关,可能成为早期DN诊断的评价指标。

Objective:To explore the relationship between serum cystatin C(CysC),complement C1q,fibroblast growth factor 21(FGF21),growth differentiation factor 15(GDF15)and the severity of diabetic nephropathy(DN).Method:The clinical data of 150 patients with type 2 diabetes(T2DM)admitted to Yong’an Branch of Liuyang People’s Hospital from May 2019 to May 2021 were analyzed retrospectively.According to the 24 h urinary albumin excretion rate(UAER),they were divided into early diabetic nephropathy(EDKD)group(56 cases),clinical diabetic nephropathy(CDN)group(49 cases)and simple type 2 diabetes mellitus(T2DM)group(45 cases),and 35 healthy people were selected to be included in the control group.Collected serum samples from each group separately,the levels of serum CysC,complement C1q,FGF21,GDF15,glycated hemoglobin A1c(HbA1c),fasting insulin(FINS),blood urea nitrogen(BUN),uric acid(UA)and insulin resistance index(HOMA-IR)were detected and compared in each group.Result:The levels of CysC,complement C1q,FGF21 and GDF15,HbA1c,FINS,BUN,UA,HOMA-IR in T2DM group,EDKD group and CDN group were significantly higher than those in control group(P<0.001).The levels of CysC,complement C1q,FGF21 and GDF15,HbA1c,FINS,BUN,UA,HOMA-IR in EDKD group and CDN group were significantly higher than those in T2DM group(P<0.001).The levels of CysC,complement C1q,FGF21 and GDF15,HbA1c,FINS,BUN,UA,HOMA-IR in CDN group were significantly higher than those in EDKD group(P<0.001).Pearson correlation analysis showed that CysC,complement C1q,FGF21 and GDF15 were positively correlated with HbA1c,FINS,BUN,UA,HOMA-IR and UAER in early DN patients(P<0.05).Conclusion:The expression levels of CysC,complement C1q,FGF21 and GDF15 in the serum of DN patients are relatively high,and they are related to the severity of the disease in DN patients,and they may become evaluation indicators for the diagnosis of diabetic nephropathy.