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青少年糖尿病患者的血清胱抑素C:青少年糖尿病研究(SEARCH)

Serum cystatin C in youth with diabetes: The SEARCH for diabetes in youth study.

作者信息

Kanakatti Shankar Roopa, Dolan Lawrence M, Isom Scott, Saydah Sharon, Maahs David M, Dabelea Dana, Reynolds Kristi, Hirsch Irl B, Rodriguez Beatriz L, Mayer-Davis Elizabeth J, Marcovina Santica, D'Agostino Ralph, Mauer Michael, Mottl Amy K

机构信息

Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.

Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.

出版信息

Diabetes Res Clin Pract. 2017 Aug;130:258-265. doi: 10.1016/j.diabres.2017.06.010. Epub 2017 Jun 12.

Abstract

AIMS

We compared cystatin C in youth with versus without diabetes and determined factors associated with cystatin C in youth with type 1 diabetes (T1D) and type 2 diabetes (T2D).

METHODS

Youth (ages 12-19years) without diabetes (N=544) were ascertained from the NHANES Study 2000-2002 and those with T1D (N=977) and T2D (N=168) from the SEARCH for Diabetes in Youth Study. Adjusted means of cystatin C concentrations were compared amongst the 3 groups. Next, we performed multivariable analyses within the T1D and T2D SEARCH samples to determine the association between cystatin C and race, sex, age, diabetes duration, HbA1c, fasting glucose, and BMI.

RESULTS

Adjusted cystatin C concentrations were statistically higher in NHANES (0.85mg/L) than in either the T1D (0.75mg/L) or T2D (0.70mg/L) SEARCH groups (P<0.0001). Fasting glucose was inversely related to cystatin C only in T1D (P<0.001) and BMI positively associated only in T2D (P<0.01) while HbA1c was inversely associated in both groups.

CONCLUSIONS

Cystatin C concentrations are statistically higher in youth without diabetes compared to T1D or T2D, however the clinical relevance of this difference is quite small, especially in T1D. In youth with diabetes, cystatin C varies with BMI and acute and chronic glycemic control, however their effects may be different according to diabetes type.

摘要

目的

我们比较了患有和未患糖尿病的青少年的胱抑素C水平,并确定了1型糖尿病(T1D)和2型糖尿病(T2D)青少年中与胱抑素C相关的因素。

方法

从2000 - 2002年美国国家健康与营养检查调查(NHANES)中确定了544名无糖尿病的青少年(年龄12 - 19岁),并从青少年糖尿病研究(SEARCH)中确定了977名T1D和168名T2D青少年。比较了三组中胱抑素C浓度的校正均值。接下来,我们在T1D和T2D的SEARCH样本中进行多变量分析,以确定胱抑素C与种族、性别、年龄、糖尿病病程、糖化血红蛋白(HbA1c)、空腹血糖和体重指数(BMI)之间的关联。

结果

NHANES组(0.85mg/L)的校正胱抑素C浓度在统计学上高于T1D组(0.75mg/L)和T2D组(0.70mg/L)的SEARCH组(P<0.0001)。仅在T1D中空腹血糖与胱抑素C呈负相关(P<0.001),仅在T2D中BMI与胱抑素C呈正相关(P<0.01),而HbA1c在两组中均呈负相关。

结论

与T1D或T2D相比,无糖尿病的青少年中胱抑素C浓度在统计学上更高,然而这种差异的临床相关性相当小,尤其是在T1D中。在患有糖尿病的青少年中,胱抑素C随BMI以及急性和慢性血糖控制而变化,然而其影响可能因糖尿病类型而异。

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