2型糖尿病患者血清胆红素与半胱氨酸蛋白酶抑制剂C的相关性研究  

Correlation between serum bilirubin and cystatin C in patients with type 2 diabetes mellitus

作　　者：李吉镇 王娜[2] 陈汉文 董国霞[2] 钱一苇 刘雷[2] Li Jizhen;Wang Na;Chen Hanwen;Dong Guoxia;Qian Yiwei;Liu Lei(Clinical Medical College of Jining Medical University,Shandong Jining 272067,China;Department of General Medicine,Affiliated Hospital of Jining Medical University,Shandong Jining 272029,China)

机构地区：[1]济宁医学院临床医学院,山东济宁272067 [2]济宁医学院附属医院全科医学科,山东济宁272029

出　　处：《中国医师进修杂志》2021年第7期585-590,共6页Chinese Journal of Postgraduates of Medicine

基　　金：济宁医学院附属医院博士科研基金(2020-BS-014)。

摘　　要：目的探讨2型糖尿病患者血清胆红素与半胱氨酸蛋白酶抑制剂C(CysC)的相关性。方法对2017年6月至2018年5月济宁医学院附属医院750例2型糖尿病患者进行回顾性队列研究,收集其临床资料,分析血清总胆红素、直接胆红素、间接胆红素与CysC的相关性。结果根据单因素分析结果,调整相关混杂因素后平滑曲线拟合显示,总胆红素、间接胆红素与CysC呈U型关系;当总胆红素<15.9μmol/L时,总胆红素每增加1μmol/L,CysC降低0.008 mg/L(β=-0.008,95%CI-0.014~-0.002,P<0.01);当间接胆红素<11.5μmol/L时,间接胆红素每增加1μmol/L,CysC降低0.011 mg/L(β=-0.011,95%CI-0.018~-0.003,P<0.01)。CysC按照正常范围(CysC<1.25 mg/L)进行分组,调整相关混杂因素后平滑曲线拟合显示,总胆红素和间接胆红素与CysC呈U型关系;总胆红素<15.5 mol/L时,总胆红素每增加1μmol/L,CysC超出正常值的风险降低17%(OR=0.83,95%CI 0.71~0.96,P<0.01);总胆红素≥15.5μmol/L,总胆红素每增加1μmol/L,CysC超出正常值的风险增加12%(OR=1.12,95%CI 1.01~1.25,P<0.05);间接胆红素<11.8μmol/L时,间接胆红素每增加1μmol/L,CysC超出正常值的风险降低20%(OR=0.80,95%CI 0.67~0.95,P<0.01)。直接胆红素与CysC无相关性。结论总胆红素和间接胆红素与CysC呈U型关系,生理浓度下,总胆红素与间接胆红素升高可以降低CysC。Objective To study the correlation between serum bilirubin and cystatin C in patients with type 2 diabetes mellitus.Methods A retrospective cohort study was conducted on 750 patients who were in the Affiliated Hospital of Jining Medical University from June 2017 to May 2018.The clinical data were collected,and the correlation between serum total bilirubin,direct bilirubin,indirect bilirubin and cystatin C was analyzed.Results According to the results of single factor analysis,after adjusting the related confounding factors,the smooth curve fitting showed that there was a U-shaped relationship between the total bilirubin,indirect bilirubin and cystatin C.When the total bilirubin was<15.9μmol/L,for every increase of 1μmol/L in total bilirubin,cystatin C decreased 0.008 mg/L(β=-0.008,95%CI-0.014 to-0.002,P<0.01);when indirect bilirubin was<11.5μmol/L,for every increase of 1μmol/L in indirect bilirubin,cystatin C decreased 0.011 mg/L(β=-0.011,95%CI-0.018 to-0.003,P<0.01).When cystatin C was grouped according to the normal range(cystatin C<1.25 mg/L),after adjusting the related confounding factors,the smooth curve fitting showed that there was a U-shaped relationship between the total bilirubin and indirect bilirubin with cystatin C;when total bilirubin was<15.5 mol/L,for every increase of 1μmol/L in total bilirubin,the risk of cystatin C exceeding the normal value was reduced by 17%(OR=0.83,95%CI 0.71 to 0.96,P<0.01);when total bilirubin was≥15.5μmol/L,for every increase of 1μmol/L in total bilirubin,the risk of cystatin C exceeding the normal value was increased by 12%(OR=1.12,95%CI 1.01 to 1.25,P<0.05);when indirect bilirubin was<11.8μmol/L,every increase of 1μmol/L in indirect bilirubin,the risk of cystatin C exceeding the normal value was reduced by 20%(OR=0.80,95%CI 0.67 to 0.95,P<0.01).However there was no significant correlation between direct bilirubin and cystatin C.Conclusions There is a U-shaped relationship between total bilirubin,indirect bilirubin and cystatin C.At physiological concentrati

关 键 词：糖尿病 2型 胆红素 半胱氨酸蛋白酶抑制剂C 队列研究 

分 类 号：R587.1[医药卫生—内分泌]