Galicka-Latała Danuta, Fedak Danuta, Kuźniewski Marek, Kawalec Ewa, Solnica Bogdan
Katedra i Klinika Chorób Metabolicznych, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
Przegl Lek. 2004;61(3):155-8.
In the last few years much attention is being given to the problem of diabetes mellitus, to it's development, prevalence and progression of chronic complications. The aim of the study was to 1. evaluate correction of metabolic disturbances in patients with long-term type 1 diabetes mellitus; 2. evaluate occurrence of diabetic nephropathy and excretion function in patients with long-term type 1 diabetes mellitus; 3. evaluate function of the cardiovascular autonomic nervous system in patients with long-term type 1 diabetes mellitus; 4. search for connections between the type and change dynamics in the cardiovascular system and degree of diabetic nephropathy advancement. The study was performed in a group consisting of 31 patients with type 1 diabetes mellitus (20 women, 11 males). Mean age of the study group equaled 37.6 +/- 10.75 years, duration of diabetes mellitus 21.3 +/- 9.55 years. Concentration of cystatin C in the study group was 0.98 +/- 0.23 ng/ml, in the group of patients with diabetic retinopathy 1.13 +/- 0.30 ng/ml, while in the group without diabetic retinopathy 0.89 +/- 0.13 ng/ml. Concentration of cystatin C (p <0.05) and calculated GFR according to equations proposed by F.J. Hoeck [GFR/1.73 m2 = -4.32 + 80.3/plasma cystatin] (p < 0.01) also G.D. Tan [GFR -10 = (87.1/plasma cystine) - 6.87] (p < 0.01) significantly differentiated the discussed groups.
despite normal levels of blood creatinine in the studied patients, decreased glomerular filtration was calculated for plasma cystatin C. Plasma cystatin C concentrations and calculated glomerular clearance significantly differentiated the group with retinopathy from the group without diabetic retinopathy. Determining cystatin C concentrations as a protein which probably does not undergo glycation in plasma, may play a role in the detection of early diabetic nephropathy, when as well as plasma creatinine levels and albumin/creatinine index calculated from a sample of morning urine do not differentiate the studied group of patients.
在过去几年中，糖尿病问题及其慢性并发症的发展、患病率和进展受到了广泛关注。本研究的目的是：1. 评估长期1型糖尿病患者代谢紊乱的纠正情况；2. 评估长期1型糖尿病患者糖尿病肾病的发生情况及排泄功能；3. 评估长期1型糖尿病患者心血管自主神经系统的功能；4. 寻找心血管系统类型和变化动态与糖尿病肾病进展程度之间的联系。该研究在一组由31例1型糖尿病患者（20名女性，11名男性）组成的人群中进行。研究组的平均年龄为37.6±10.75岁，糖尿病病程为21.3±9.55年。研究组中胱抑素C的浓度为0.98±0.23 ng/ml，糖尿病视网膜病变患者组为1.13±0.30 ng/ml，无糖尿病视网膜病变患者组为0.89±0.13 ng/ml。胱抑素C的浓度（p<0.05）以及根据F.J. Hoeck提出的公式计算的肾小球滤过率[GFR/1.73 m2 = -4.32 + 80.3/血浆胱抑素]（p<0.01），还有G.D. Tan提出的公式[GFR -10 = (87.1/血浆胱抑素) - 6.87]（p<0.01）也显著区分了所讨论的组。
尽管所研究患者的血肌酐水平正常，但根据血浆胱抑素C计算出肾小球滤过率降低。血浆胱抑素C浓度和计算出的肾小球清除率显著区分了有视网膜病变的组和无糖尿病视网膜病变的组。当血浆肌酐水平以及根据晨尿样本计算的白蛋白/肌酐指数无法区分所研究的患者组时，测定胱抑素C浓度作为血浆中可能未发生糖基化的一种蛋白质，可能在早期糖尿病肾病的检测中发挥作用。
