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选择T2DM患者123例,根据尿中微量白蛋白(MA)与尿中肌酐(Cre)比值分为3组:正常白蛋白尿组(MA/Cre<30μg/mg)40例;微量白蛋白尿组(MA/Cre 30～300μg/mg)42例;临床蛋白尿组(MA/Cre>300μg/mg)41例。健康体检人群40例为对照。测定血清CysC、MA/Cre、空腹血糖(FPG)、糖化血红蛋白(HbA1c)进行比较,并探讨CysC与MA/Cre、FPG、HbA1c的相关性。结果:T2DM各组CysC、MA/Cre、FPG、HbA1c均较正常对照组明显升高,有统计学意义(P<0.01)。正常白蛋白尿组、微量白蛋白尿组和临床蛋白尿组CysC值、MA/Cre值各组间比较均有显著性差异(P<0.01)。临床蛋白尿组HbA1c、FPG较微量白蛋白组、正常白蛋白尿组明显升高(P<0.01),微量白蛋白尿组HbA1c、FPG较正常白蛋白尿组明显升高(P<0.05),且CysC水平与MA/Cre、HbA1c有良好的正相关性。结论:血清胱抑素C随肾脏损害程度的增加而逐渐升高,可作为糖尿病早期肾损害检测指标。
According to the ratio of urinary albumin (MA) to urinary creatinine (Cre), 123 patients with T2DM were divided into 3 groups: 40 cases of normal albuminuria (MA / Cre <30μg / mg); 40 cases of microalbuminuria (MA / Cre 30 ~ 300μg / mg) in 42 cases; clinical proteinuria group (MA / Cre> 300μg / mg) in 41 cases. Health examination population 40 cases as a control. Serum levels of CysC, MA / Cre, fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c) were measured and compared. The correlation between CysC and MA / Cre, FPG and HbA1c was also discussed. Results: The levels of CysC, MA / Cre, FPG and HbA1c in T2DM group were significantly higher than those in control group (P <0.01). There were significant differences in CysC and MA / Cre between normal albuminuria group, microalbuminuria group and clinical proteinuria group (P <0.01). HbA1c and FPG levels in clinical albuminuria group were significantly higher than those in microalbumin group and normal albuminuria group (P <0.01). HbA1c and FPG in microalbuminuria group were significantly higher than those in normal albumin group (P <0.05) And CysC level with MA / Cre, HbA1c has a good positive correlation. Conclusion: Serum cystatin C increases gradually with the increase of renal damage, which can be used as an indicator of early diabetic nephropathy.