Jeon You La, Kim Myeong Hee, Lee Woo-In, Kang So Young
Department of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, Seoul 134-727, The Republic of Korea.
Clin Lab. 2013;59(11-12):1221-9. doi: 10.7754/clin.lab.2013.120804.
Serum cystatin C has been proposed as an endogenous marker of glomerular filtration rate (GFR) because it shows a correlation with the albumin to creatinine ratio (ACR) in diabetic nephropathy. The aim of this study was to examine the usefulness of cystatin C as an early marker of diabetic nephropathy.
From February 2010 to July 2010, 205 outpatients with normo- or microalbuminuria and chronic kidney disease (CKD) of stage III or less were included in this study. Various renal markers including serum cystatin C and ACR were evaluated.
In the ROC curve analysis, cystatin C showed a performance similar to that of serum creatinine. In addition, cystatin C levels increased with increasing CKD stage I to III and from normo- to microalbuminuria and showed a positive correlation with ACR. In a comparison of renal function markers in diabetic patients according to serum cystatin C level, all markers including ACR, serum creatinine, and eGFR showed significant differences between patients with cystatin C level < 1.06 mg/L and those with cystatin C > or = 1.06 mg/L.
Serum cystatin C is a useful marker of early renal impairment in type 2 diabetic patients because it reflects both a decrease in GFR and elevated ACR.
血清胱抑素C已被提议作为肾小球滤过率（GFR）的内源性标志物，因为它在糖尿病肾病中与白蛋白肌酐比值（ACR）相关。本研究的目的是检验胱抑素C作为糖尿病肾病早期标志物的有效性。
2010年2月至2010年7月，本研究纳入了205例患有正常白蛋白尿或微量白蛋白尿且慢性肾脏病（CKD）为III期或更低分期的门诊患者。对包括血清胱抑素C和ACR在内的各种肾脏标志物进行了评估。
在ROC曲线分析中，胱抑素C的表现与血清肌酐相似。此外，胱抑素C水平随着CKD分期从I期到III期以及从正常白蛋白尿到微量白蛋白尿的增加而升高，并且与ACR呈正相关。在根据血清胱抑素C水平对糖尿病患者的肾功能标志物进行比较时，包括ACR、血清肌酐和估算肾小球滤过率（eGFR）在内的所有标志物在胱抑素C水平<1.06mg/L的患者与胱抑素C≥1.06mg/L的患者之间均显示出显著差异。
血清胱抑素C是2型糖尿病患者早期肾脏损害的有用标志物，因为它既反映了GFR的降低，也反映了ACR的升高。
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