老年2型糖尿病肾病患者血清胰岛素样生长因子1及胱抑素C与糖尿病肾病的相关性  

Correlation between serum insulin-like growth factor 1 and cystatin C and elderly patients with type 2 diabetic nephropathy

作　　者：陈敏[1] 方小正[1] CHEN Min;FANG Xiaozheng(Department of Geriatrics,Huai′an First Peoples Hospital,Nanjing Medical Uniersity,Huai′an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院老年医学科,江苏淮安223300

出　　处：《实用医学杂志》2018年第18期3060-3062,共3页The Journal of Practical Medicine

基　　金：淮安市科技支撑计划(编号:HAS2015031-4)

摘　　要：目的分析血清胰岛素样生长因子1(IGF-1)水平及血清胱抑素C在2型糖尿病(T2DM)肾病患者中的变化及临床意义。方法 2型糖尿病患者192例,按照患者的尿白蛋白排泄率状况,将尿白蛋白排泄率<20μg/min的64例糖尿病患者分为单纯2型糖尿病组(A组),尿白蛋白排泄率范围为20~200μg/min的62例糖尿病患者分为早期糖尿病肾病(DN)组(B组),尿蛋白排泄率> 200μg/min的66例糖尿病患者分为临床期DN组(C组)。同期行健康体检的60例健康人群作为对照组。通过化学发光组与透射比浊法对四组的血清胰岛素样生长因子1水平与胱抑素C水平进行检测。结果 C组患者的冠心病病史与脑梗塞病史率显著高于A组与B组患者,差异有统计学意义(P <0.05);A组、B组及C组患者IGF-1水平[(176.41±12.62)mg/L、(222.31±24.96)mg/L、(249.12±36.14)mg/L]显著高于对照组,差异有统计学意义(P <0.05);B组及C组IGF-1水平较A组明显升高,差异有统计学意义(P <0.05);B组及C组血清胱抑素C水平较对照组、A组明显升高,差异有统计学意义(P <0.05)。结论 IGF-1水平与血清胱抑素C水平与糖尿病肾病的病变程度有显著相关性,可作为该疾病的早期重要诊断指标。Objective To investigate the changes and clinical significance of serum insulin-like growth factor-1(IGF-1)and serum cystatin C in patients with type 2 diabetic nephropathy(DN).Methods A total of 192 patients with type 2 diabetes mellitus were divided into three groups according to urinary albumin excretion rate(UAER),including 64 patients with normoalbuminuric type 2 diabetic patients(Group A,UAER<20μg/min),62 patients with microalbuminuria(Group B,20μg/min<UAER<200μg/min)and 66 patients with macroalbu-minuria(Group C,UAER>200μg/min).Meanwhile,60 healthy people were collected as a normal control group.Immunochemiluminescence and immunoturbidimetric assays were used to detect the serum IGF-1 and cystatin C concentrations in the four groups.Results The clinical history of CHD and the history of cerebral infarction were significantly higher in patients with macroalbuminuria than in patients without proteinuria or with microalbuminuria(P<0.05).The expression of IGF-1 was siginificantly increased in case group than those in the control group(P<0.05).The levels of IGF-1 in microalbuminuria group and macroalbuminuria group were significantly higher than those in normoalbuminuric type 2 diabetic group(P<0.05).The serum levels of cystatin C levels in microalbumin-uria group and macroalbuminuria group were significantly higher than those in control group and normoalbuminuric type 2 diabetic group(P<0.05).Conclusion The levels of IGF-1 and cystatin C were associated with the pro-gression of DN.It may serve as an important diagnostic indicator for early DN.

关 键 词：糖尿病肾病 血清胰岛素样生长因子1 胱抑素C 老年人 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]