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尿胱抑素 C 作为 2 型糖尿病患者早期肾功能障碍的生物标志物。

Urinary cystatin C as a biomarker of early renal dysfunction in type 2 diabetic patients.

机构信息

Specialist of Internal Medicine, Specialized Medical Hospital, Mansoura University, Egypt.

Endocrinology & Diabetes Unit, Faculty of Medicine, Mansoura University, Egypt.

出版信息

Diabetes Metab Syndr. 2021 Jul-Aug;15(4):102152. doi: 10.1016/j.dsx.2021.05.025. Epub 2021 May 25.

DOI:10.1016/j.dsx.2021.05.025
PMID:34186366
Abstract

AIMS

We aimed to evaluate urinary CysC (cystanin c) as an early marker of diabetic nephropathy in patients with type 2 diabetes and investigate the correlation of urinary CysC with albuminuria and GFR.

METHODOLOGY

This case-controlled study was conducted on 66 type 2 diabetic patients who were classified according to albuminuria into 3 groups and consisting of 20 healthy subjects as the control group. We assessed urinary CysC, urinary albumin excretion rate (UACR).

RESULTS

Urinary CysC levels were significantly higher in normoalbuminuric diabetic compared with healthy control and there was a progressive linear increase in urinary CysC levels with increasing albuminuria in the diabetic patients. Despite insignificant deference in creatinine between participants groups, we observed significant differences between these groups as regard eGFR, urinary CysC, and UACR. Urinary CysC did not have significant correlations with any clinical or biochemical parameters. Moreover, urinary CysC had a statistically significant association with albuminuria and eGFR.

CONCLUSION

Urinary CysC levels correlated with UACR and GFR. It is linked to subclinical tubular injury and can be an earlier marker of kidney involvement, even before albuminuria and it is less influenced by non-renal factors. Therefore, Urinary CysC is useful biomarker for early diagnosis of diabetic nephropathy.

摘要

目的

本研究旨在评估 2 型糖尿病患者尿胱抑素 C(cystatin C)作为糖尿病肾病早期标志物的作用,并探讨其与蛋白尿和肾小球滤过率(GFR)的相关性。

方法

本病例对照研究纳入了 66 例 2 型糖尿病患者,根据蛋白尿将其分为 3 组,其中 20 例健康受试者作为对照组。我们评估了尿胱抑素 C 和尿白蛋白排泄率(UACR)。

结果

与健康对照组相比,尿胱抑素 C 在正常白蛋白尿的糖尿病患者中明显升高,且随着糖尿病患者蛋白尿的增加,尿胱抑素 C 水平呈线性升高。尽管参与者组之间的肌酐无显著差异,但我们观察到这些组之间在 eGFR、尿胱抑素 C 和 UACR 方面存在显著差异。尿胱抑素 C 与任何临床或生化参数均无显著相关性。此外,尿胱抑素 C 与白蛋白尿和 eGFR 具有统计学显著关联。

结论

尿胱抑素 C 水平与 UACR 和 GFR 相关。它与亚临床肾小管损伤有关,甚至在白蛋白尿之前就可以作为肾脏受累的早期标志物,且受非肾脏因素的影响较小。因此,尿胱抑素 C 是早期诊断糖尿病肾病的有用生物标志物。

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