2型糖尿病早期肾损害患者血清胱抑素C水平与尿微量白蛋白肌酐比值的变化及意义

Changes and significance of serum cystatin C level and urinary microalbumin-creatinine ratio in patients with type 2 diabetes mellitus complicated by early renal injury

目的探讨2型糖尿病(T2DM)早期肾损害患者血清胱抑素C(CysC)水平与尿微量白蛋白肌酐比值(mAlb/Cr)的变化及意义。方法抽取2020年6月至2022年5月聊城市第三人民医院收治的T2DM患者103例,按照是否存在早期糖尿病肾病(DN)分为单纯T2DM组(71例)与早期DN组(32例),检测两组患者血清CysC水平,并计算尿mAlb/Cr,分析血清CysC水平与尿mAlb/Cr的相关性,采用受试者工作特征曲线分析血清CysC水平、尿mAlb/Cr对早期DN的评估价值。结果早期DN组血清CysC水平、尿mAlb/Cr[(1.02±0.23)ng/L,46.59±10.26]高于单纯T2DM组[(0.73±0.18)ng/L,34.12±8.72],P<0.05;血清CysC水平与尿mAlb/Cr呈正相关(r=0.34,P<0.001)。受试者工作特征曲线分析结果显示,血清CysC水平、尿mAlb/Cr单独及联合评估早期DN的曲线下面积(AUC)分别为0.827、0.799、0.921,血清CysC水平与尿mAlb/Cr联合评估早期DN的AUC最大,效能最高,敏感度、特异度分别为93.80%、78.92%。结论T2DM早期肾损害患者血清CysC水平、尿mAlb/Cr呈现升高改变,二者呈正相关,二者联合评估早期DN的效能较高。

Objective To investigate the changes and significance of serum cystatin C(CysC)level and urinary microalbumin-creatinine ratio(mAlb/Cr)in patients with type 2 diabetes mellitus(T2DM)complicated by early renal injury.Methods A total of 103 patients with T2DM admitted to Liaocheng Third People’s Hospital from June 2020 to May 2022 were selected.According to occurrence of early diabetic nephropathy(DN),they were divided into T2DM group(71 cases)and early DN group(32 cases).The level of serum CysC of the two groups were detected,and urinary mAlb/Cr was calculated.The correlation between the level of serum CysC and urinary mAlb/Cr was analyzed.The value of serum CysC level and urinary mAlb/Cr in prediction of early DN was analyzed by receiver operating characteristic curve.Results The level of serum CysC and urinary mAlb/Cr in the early DN group were(1.02±0.23)ng/L and 46.59±10.26,respectively,higher than the(0.73±0.18)ng/L and 34.12±8.72 in the T2DM group(P<0.05).The serum CysC level was positively correlated with urinary mAlb/Cr(r=0.34,P<0.001).Results of receiver operating characteristic curve analysis showed that area under the curve(AUC)values of serum CysC level,urinary mAlb/Cr and combination of the two in predicting early DN were 0.827,0.799 and 0.921,respectively.AUC and evaluation efficiency of combination of the two indicators in predicting early DN were the highest,while its sensitivity and specificity were 93.80%and 78.92%,respectively.Conclusions The serum CysC level and urinary mAlb/Cr increase in patients with T2DM complicated by early renal injury.Serum CysC level is positively correlated with urinary mAlb/Cr,and the efficiency of the combination of the two is high in prediction of early DN.