Piwowar A, Knapik-Kordecka M, Buczyńska H, Warwas M
Department of Pharmaceutical Biochemistry, University Medical School, Wrocław, Poland.
Arch Immunol Ther Exp (Warsz). 1999;47(5):327-31.
We determined plasma concentrations of cystatin C, beta2-microglobulin - beta2-MG (low molecular mass protein markers of glomerular filtration rate - GFR), creatinine (marker of GFR) and urinary N-acetyl-beta-D-glucosaminidase (NAG) excretion (marker of glomerular and tubular dysfunction) in 41 non-insulin-dependent diabetic patients. A significant increase of all the measured parameters (p<0.001, p<0.05, p<0.05 and p<0.001, respectively) in comparison to the control group, was observed. In the patients with microalbuminuria, only plasma cystatin C concentration and urinary NAG excretion increased significantly in comparison to patients with normoalbuminuria. At a cut-off level of 1.74 mg/l for cystatin C and 1.81 U/g creatinine for NAG (95% percentile of the normoalbuminuric group), the sensitivity of the tests for detecting microalbuminuria was 82% for cystatin C and 86% for NAG. The specificities were 88 and 92%, respectively. The present study demonstrated that determination of plasma cystatin C might be useful in the detection of incipient diabetic nephropathy and is a potentially better marker than creatinine or beta2-MG. No correlation between parameters measured in plasma or urine and glycated hemoglobin was found.
我们测定了41例非胰岛素依赖型糖尿病患者血浆中胱抑素C、β2-微球蛋白（β2-MG，肾小球滤过率 - GFR的低分子量蛋白质标志物）、肌酐（GFR标志物）以及尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）排泄量（肾小球和肾小管功能障碍标志物）。与对照组相比，所有测量参数均显著升高（分别为p<0.001、p<0.05、p<0.05和p<0.001）。在微量白蛋白尿患者中，与正常白蛋白尿患者相比，仅血浆胱抑素C浓度和尿NAG排泄量显著增加。以胱抑素C 1.74 mg/l和NAG 1.81 U/g肌酐为临界值（正常白蛋白尿组的第95百分位数），检测微量白蛋白尿时，胱抑素C的检测敏感性为82%，NAG为86%。特异性分别为88%和92%。本研究表明，测定血浆胱抑素C可能有助于早期糖尿病肾病的检测，并且是一种比肌酐或β2-MG更有潜力的标志物。未发现血浆或尿液中测量的参数与糖化血红蛋白之间存在相关性。
