同型半胱氨酸在糖尿病肾病中的新应用  

New applications of homocysteine in diabetic nephropathy

作　　者：庄兴[1] ZHUANG Xing(Department of clinical laboratory,Shanghai Ninth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院检验科,200011

出　　处：《国际检验医学杂志》2017年第A02期27-30,共4页International Journal of Laboratory Medicine

摘　　要：目的同型半胱氨酸是否是糖尿病肾病早期又一个标记物。方法检测281名2型糖尿病患者的HCY、CYSC、CHOL、TG、HDL-C、LDL-C、GLU、CREA、HbA1C,并根据CREA做eGFR进行MDRD分组统计。结果糖尿病性肾病的进展与HCY、CYSC、CHOL、HDL-C具有显著相关性;与LDL-C相关;与TG、GLU和HbA1C无关。HCY在肾功能正常的糖尿病人群中没有变化,随着肾功能损伤加重,HCY呈明显上升趋势。HCY与MDRD呈线性回归关系,得直线回归方程:HCY=20.14-0.127MDRD,回归系数标准误为0.019。HCYROC曲线下面积为0.940。HCY值为19.65mmol/L时其敏感性为100%,特异性为91.4%。结论血浆同型半胱氨酸水平的变化在糖尿病肾脏中可能是一个敏感的早期标志物,其变化可以预测DN进展的阶段。Objective Homocysteine another marker ofearly diabetic nephropathy.Methods HCY,CYSC,CHOL,TG,HDL-C,LDL-C,GLU,CREA,and HbA1C were detected in281patients with type2diabetes mellitus,and according to CREA to do eGFR,MDRD grouping statistics.Results The progression of diabetic nephropathy was significantly related to HCY,CYSC,CHOL,HDL-C,and LDL-C,but not to TG,GLU and HbA1C,HCY has no change in the diabeticpopulation with normal renal function,and increases obviously with the aggravation of renal function damage.Linear regression relation between HCY and MDRD was obtained.The linear regression equation was HCY=20.14-0.127MDRD,and the standard error of regression coefficient was0.019.The area under the ROC curve is0.940.When the HCY value was19.65mmol/L,the sensitivity was100%and the specificity was91.4%.Conclusion Changes in plasma homocysteine levels may be a sensitive early marker in diabetic kidneys,and their changes can predict the stage of DN progression.

关 键 词：肌酐 估算肾小球滤过率 同型半胱氨酸 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]