尿胱抑素C作为糖尿病肾病早期诊断标准的评价  

Evaluation of Urinary Cystatin C as the Standard for Early Diagnosis of Diabetic Nephropathy

作　　者：史喜苗[1] 孟宪杰[1] 张明月[2] 黄燕如[1] 陈好利[1] 毛志敏[1] 吴静珠[2] 

机构地区：[1]南京中医药大学第一临床医学院,210029 [2]南京中医药大学,210029

出　　处：《医学研究杂志》2014年第8期106-108,共3页Journal of Medical Research

摘　　要：目的评估尿胱抑素C(urinary cystatin C,UCysC)与尿白蛋白/肌酐(urine albumin-creatinine ratio,UACR)的相关性,进而探讨UCysC作为糖尿病肾病(diabetic nephropathy,DN)早期诊断标准的意义。方法采取回顾性横断面研究方法,将100例糖尿病(diabetes mellitus,DM)患者依据UACR水平分为正常白蛋白尿组(n=19)、微量白蛋白尿组(n=59)和大量白蛋白尿组(n=22)。常规记录查体结果和相关生化指标,同时采用颗粒增强透射免疫比浊法(particle-enhanced turbimetric assay method)测定不同分组患者UCysC水平。结果在正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组,UCysC随着UACR的增加而逐渐升高,差异具有统计学意义(P<0.05)。UCysC与UACR之间呈正相关(r=0.766,P=0.000),以UACR值30mg/g为切入点,作ROC曲线,得出曲线下面积为0.915,这说明UCysC对于早期DN来说,具有很好的敏感度和特异性。结论 UCysC与UACR之间具有独立相关性,UCysC可以作为DN早期诊断标准。Objective This study aimed to evaluate the association between urinary cystatin C （UCysC） and urine albumin-creatinine ratio （UACR） and then to determine whether urinary cystatin C could be used as an early biomarker of renal dysfunction in diabetic patients.Methods Diabetic patients （n =100） with normoalbuminuria （n =19）,microalbuminuria （n =59） and macroalbuminuria （n =22） were enrolled in the study.Urine cystatin C,serum creatinine （Scr）,blood urine nitrogen （BUN）,urine albumin-creatinine ratio （UACR） and other blood biochemical values were determined in all groups.Particle-enhanced turbimetric assay method was used to measure urinary cystatin C levels in different groups.Results In normoalbuminuria group,microalbuminuria group and macroalbuminuria group,the urine cystatin C levels increased with increasing degree of urine ACR,and the differences between the groups were statistically significant （P ＜ 0.05）.Urine cystatin C was positively corrected with urine ACR （r =0.766,P =0.000）.Nonparametric ROC curve,using a cut of urine ACR of 30mg/g,was obtained for urine cystatin C.Area under the curve was 0.915 for urine cystatin C,which meanst that urine cystatin C was sensitive and specific in the early stage of diabetic nephropathy.Conclusion There is an independent correlation between cystatin C and urine ACR.The results of this study suggest that urinary cystatin C could be a biomaker of incipient DN.

关 键 词：糖尿病肾病 尿胱抑素C 尿白蛋白 肌酐 肾小管损伤 

分 类 号：R587[医药卫生—内分泌]