尿C肽/肌酐评估1型糖尿病残存胰岛功能及并发症风险的应用价值

The value of urinary C⁃P/creatinine in assessing residual islet function and risk of complications in type 1 diabetes mellitus

目的探讨尿C-P/肌酐(UCPCR)评估T1DM残存胰岛功能及并发症风险的应用价值。方法选取2019年1月至2020年1月于南京鼓楼医院内分泌科就诊的T1DM患者75例,以UCPCR 0.2 pmol/μmol为切点值,将T1DM患者分为有胰岛功能组19例(PF,UCPCR≥0.2 pmol/μmol)、微量胰岛功能组42例(MF,0<UCPCR<0.2 pmol/μmol)及无胰岛功能组14例(LF,UCPCR=0 pmol/μmol)。结果Pearson相关分析显示,UCPCR与FC-P、2 hC-P呈正相关(P<0.05),UCPCR<0.2 pmol/μmol时胰岛功能绝对缺乏。Spearman相关分析显示,UCPCR与DR患病率、心血管病(CVD)风险呈负相关(P<0.05),UCPCR<0.02 pmol/μmol时存在高危或极高危CVD风险。结论UCPCR是反应T1DM残存胰岛功能的敏感指标,对评估DR及CVD风险有应用价值。

Objective To explore the application value of urinary C-P/creatinine(UCPCR)in evaluating residual pancreatic islet function and the risk of complications in type 1 diabetes mellitus(T1DM)patients.Methods 75 T1DM patients who visited the Endocrinology Department of Nanjing Drum Tower Hospital from January 2019 to January 2020 were selected.Using UCPCR 0.2 pmol/μmol as the cutoff point,T1DM patients were divided into 19 patients with pancreatic function(PF,UCPCR≥0.2 pmol/μmol),42 patients with minimal pancreatic function(MF,0<UCPCR<0.2 pmol/μmol),and 14 patients without pancreatic function(LF,UCPCR=0 pmol/μmol).Results Pearson correlation analysis showed that UCPCR was positively correlated with FC-P and 2 hC-P(P<0.05).When UCPCR was less than 0.2 pmol/μmol,pancreatic islet function was absolutely lacking.Spearman correlation analysis showed that UCPCR was negatively correlated with the incidence of DR and the risk grading of cardiovascular disease(CVD)(P<0.05).When UCPCR<0.02 pmol/μmol,there was a high or extremely high risk of CVD.Conclusion 24-hour UCPCR is a sensitive indicator of residual pancreatic islet function and has potential application value in assessing the risk of diabetic retinopathy and cardiovascular disease in patients with T1DM.