a Department of Gerontology, South Campus, Renji Hospital School of Medicine , Shanghai Jiaotong University , Shanghai , China.
Clin Exp Hypertens. 2017;39(4):382-387. doi: 10.1080/10641963.2017.1288739. Epub 2017 May 17.
To investigate the diagnostic level of cystatin C and growth arrest-specific gene 6 (Gas6) levels in elderly type 2 diabetic patients with different degrees of diabetic nephropathy (DN).
Four hundred and eighty-two old people, including 130 healthy controls, 130 normoalbuminuric diabetic patients, 122 with microalbuminuria, and 100 with macroalbuminuria, were recruited. Plasma Gas6 and serum cystatin C levels were measured.
Plasma Gas6 concentration was significantly lower in diabetic patients with microalbuminuria or macroalbuminuria, as compared with diabetic subjects with normoalbuminuria; while cystatin C was significantly higher. Gas6 was inversely correlated with BMI, WHR, and HbA1c, while cystatin C was inversely correlated with urea nitrogen and creatinine. Multivariate logistic regression analysis showed that, after adjusted for established diabetes risk factors, higher plasma Gas6 was significantly associated with a decreased risk of DN, while higher serum cystatin C was significantly associated with an increased risk. Receiver operating characteristic curve analysis showed that Gas6 was better than cystatin C as a biomarker for early diagnosis and detection of DN, with a cutoff value of 9.435 ng/mL (86.1% sensitivity and 84.6% specificity).
Compared to cystatin C, Gas6 may be potentially a better noninvasive diagnostic biomarker for early detection of DN.
探讨胱抑素 C 和生长停滞特异性基因 6（Gas6）水平在不同程度老年 2 型糖尿病肾病（DN）患者中的诊断水平。
招募了 482 名老年人，包括 130 名健康对照者、130 名正常白蛋白尿糖尿病患者、122 名微量白蛋白尿患者和 100 名大量白蛋白尿患者。测定血浆 Gas6 和血清胱抑素 C 水平。
与正常白蛋白尿糖尿病患者相比，微量白蛋白尿或大量白蛋白尿的糖尿病患者的血浆 Gas6 浓度明显降低，而胱抑素 C 水平明显升高。Gas6 与 BMI、WHR 和 HbA1c 呈负相关，而胱抑素 C 与尿素氮和肌酐呈负相关。多因素 logistic 回归分析表明，在校正了已确定的糖尿病危险因素后，较高的血浆 Gas6 与 DN 风险降低显著相关，而较高的血清胱抑素 C 与 DN 风险增加显著相关。受试者工作特征曲线分析显示，Gas6 作为早期诊断和检测 DN 的生物标志物优于胱抑素 C，其截断值为 9.435ng/ml（86.1%的敏感性和 84.6%的特异性）。
与胱抑素 C 相比，Gas6 可能是早期检测 DN 的一种潜在更好的非侵入性诊断生物标志物。
