血清CysC、CRP及GADA与糖尿病肾病患者病变严重程度及心血管事件的关系  

Association of serum CysC,CRP and GADA with lesion severity and cardiovascular events in patients with diabetic nephropathy

作　　者：匡蕾[1] 戴武[1] 邹玲玲[1] 张苏皖[1] KUANG Lei;DAI Wu;ZOU Lingling;ZHANG Suwan(Department of Endocrinology,the Second People's Hospital of Hefei,Hefei,Anhui,China,230001)

机构地区：[1]合肥市第二人民医院内分泌科,安徽合肥230001

出　　处：《分子诊断与治疗杂志》2023年第4期660-664,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽医科大学科研基金项目(2020xkj248)。

摘　　要：目的 探讨血清血清胱抑素C(CysC)、C反应蛋白(CRP)及谷氨酸脱羧酶抗体(GADA)与糖尿病肾病(DN)患者病变严重程度及患者是否发生不良心血管事件(MACE)的关系。方法 选取2019年01月至2021年9月于合肥市第二人民医院就诊的DN患者92例记为DN组,选取同时期同医院就诊无肾病糖尿病(DM)患者43例记为DM组、常规体检健康志愿者50例记为健康对照组,比较三组血清CysC、CRP和GADA水平;比较不同Mogensen分期的DN患者血清CysC、CRP和GADA水平,并采用Spearman分析法分析血清各指标水平与DN患者Mogensen分期的相关性;随访1年,根据有无发生不良心血管事件(MACE)分文MACE组(n=36)与非MACE组(n=56),进行因素分析并绘制ROC曲线验证血清CysC、CRP和GADA水平对DN患者是否发生MACE的诊断效能。结果 DN组、DM组与健康对照组血清CysC、CRP和GADA水平比较,差异具有统计学意义(P<0.05),其中DN组水平最高;DN患者Ⅰ期、Ⅱ期与Ⅲ期~Ⅴ期的血清CysC、CRP、GADA水平比较,差异具有统计学意义(P<0.05),Mogensen分期越高指标水平越高;Spearman相关性分析法结果显示,DN患者血清CysC、CRP、GADA水平与DN患者Mogensen分期均呈正相关(P<0.05);因素分析结果显示,年龄、TG、CysC、CRP以及GADA是DN患者是否发生MACE影响因素(P<0.05);ROC曲线结果显示DN患者血清CysC、CRP、GADA水平与三项指标联合诊断DN患者是否发生MACE曲线下面积(AUC)分别为0.720、0.695、0.794、0.868,均具有良好的诊断效能(P<0.05),其中联合诊断高于单项诊断。结论血清CysC、CRP及GADA与患者Mogensen分期呈正相关,可反应病情的严重程度,同时对心血管事件有较高的诊断价值,或可将上述指标用于早期疾病严重程度评估及心血管事件的有效防治中。Objective To investigate the association of serum cystatin C(CysC),C-reactive protein(CRP)and glutamic acid decarboxylase antibodies(GADA)with the severity of the disease and the occurrence of major adverse cardiovascular events(MACE)in patients with diabetic nephropathy(DN).Methods Ninety two DN patients who visited the second people's Hospital of Hefei from January 2019 to September 2021 were selected and classified as the DN group,43 patients with diabetes without nephropathy(DM)who were admitted to the same hospital at the same time were selected as the DM group,and 50 healthy volunteers who were admitted to the regular physical examination were recorded as the healthy control group to compare the serum CysC,CRP and GADA levels among the three groups.The serum levels of CysC,CRP and GADA between DN patients with different Mogensen stages were compared.The correlation between the levels of each indicator in serum and the Mogensen stages of DN patients was analyzed by Spearman analysis.Followed up for 1 year,according to the occurrence of MACE in the MACE group(n=36)and the non-MACE group(n=56),factor analysis was performed and ROC curve was drawn to verify the relationship between serum CysC,CRP and GADA levels.Results The levels of CysC,CRP and GADA in the DN group,the DM group and the healthy control group were significantly different(P<0.05),and the DN group had the highest level.The serum levels of CysC,CRP and GADA in DN patients with stagesⅠ,Ⅱvs stagesⅢto V had significantly different(P<0.05).The higher the Mogensen stage,the higher the index level;the results of Spearman correlation analysis showed that the serum levels of CysC,CRP,and GADA in DN patients were positively correlated with the Mogensen stage of DN patients(P<0.05).The results of factor analysis showed that age,TG,CysC,CRP and GADA were the influencing factors for the occurrence of MACE in DN patients(P<0.05).The ROC curve results showed that the combination of serum CysC,CRP and GADA levels with the three indicators in diagnosing DN

关 键 词：血清血清胱抑素C C反应蛋白 谷氨酸脱羧酶抗体 糖尿病肾病 心血管事件 

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