尿C肽浓度和尿C肽肌酐比评价空腹血清C肽水平低于检测下限的1型糖尿病患者残余β细胞功能的研究  

Urine C⁃peptide concentration and urine C⁃peptide creatinine ratio could predict residualβ⁃cell function in type 1 diabetes mellitus with undetectable fasting serum C⁃peptide

作　　者：高颖[1] 王棪嫒 刘蔚[1] 韩学尧[1] 梁红[1] 周灵丽[1] 纪立农[1] GAO Ying;WANG Yanai;LIU Wei(Department of Endocrinology and Metabolism,People’s Hosptial of Peking University,Beijing 100044,China)

机构地区：[1]北京大学人民医院内分泌代谢科,100044

出　　处：《中国糖尿病杂志》2023年第3期201-204,共4页Chinese Journal of Diabetes

摘　　要：目的探讨以尿C-P水平(UC-P)或UC-P/尿Cr(UCPCR)评价T1DM患者残余β细胞功能的价值。方法选取94例FC-P水平低于检测下限的T1DM患者,测定餐后2 h C-P(PC-P)。晨起收集患者空腹尿测定UC-P和UCr。结果94例患者中,19例(20.2%)PC-P>0.01 ng/ml的为残余β细胞功能(Res)组,75例(79.8%)PC-P<0.01 ng/ml的为β细胞功能衰竭(Dep)组。与Dep组相比,Res组UC-P[0.177(0.073,0.238)vs 0.022(0,0.042)ng/ml]和UCPCR[0.011(0.004,0.021)vs 0.001(0,0.004)nmol/mmol]升高(P<0.01),发生DKA比例降低(50.0%vs 75.0%,P=0.044)。Pearson相关分析显示,UC-P、UCPCR与PC-P呈正相关(r=0.970、0.937,P<0.01)。受试者工作特征曲线分析显示,UCP>0.058 ng/ml或UCPCR>0.048 nmol/mmol可作为预测残余β细胞功能的筛查切点。结论测定UCP或UCPCR无创、方便、灵敏,可替代PC-P用来评价FC-P低于检测下限的T1DM患者残余β细胞功能。Objective To assess the performances of urinary C-peptide(UC-P)and urine C-peptide creatinine ratio(UCPCR)on evaluating residualβ-cell function in type 1 diabetes mellitus(T1DM).Methods A total of 94 T1DM patients with undetectable fasting C-peptide(FC-P)were enrolled.Postprandial C-peptide(PC-P)at 2 h after mixed-meal was analyzed.Urine was collected at morning for measuring urinary C-peptide and creatinine.Results Among 94 patients with T1DM and undectable FC-P,19(20.2%)patients had detectable PC-P(residualβ-cell function,Res group)and PC-P levels of the other 75(79.2%)patients were below the lower detection limit(depletedβ-cell function,Dep group).Compare to Dep group,Res group showed higher UC-P levels[0.177(0.073,0.238)vs 0.022(0,0.042)ng/ml,P<0.001],higher UCPCR[0.011(0.004,0.021)vs 0.001(0,0.004)nmol/mmol,P<0.01],and lower risk of DKA(50.0%vs 75.0%,P=0.044).The UC-P or UCPCR was tightly correlated with PC-P(r=0.970,0.937,P<0.01).UC-P over than 0.058 ng/ml with a sensitivity of 100%and a specificity of 89.9%,or UCPCR over than 0.048 nmol/mmol with a sensitivity of 84.6%and a specificity of 85.5%,was non-invasive parameter for identifying patients with T1DM with residual beta cell function.Conclusion UC-P or UCPCR testing is a sensitive method for detecting residual insulin secretion in T1DM with undetectable FC-P.

关 键 词：尿C肽 尿C肽与肌酐比 Β细胞功能 糖尿病 1型 

分 类 号：R587.1[医药卫生—内分泌]