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尿 C 肽/肌酐比值在不同肾功能水平的 2 型糖尿病患者中的应用。

Application of urine C-peptide creatinine ratio in type 2 diabetic patients with different levels of renal function.

机构信息

Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.

Anhui Provincial Hospital, Affiliated to Anhui Medical University, Hefei, China.

出版信息

Front Endocrinol (Lausanne). 2022 Nov 17;13:1052794. doi: 10.3389/fendo.2022.1052794. eCollection 2022.

Abstract

OBJECTIVE

This study aims to investigate the effect of single urine C peptide/creatinine (UCPCR) in assessing the islet β Cell function of type 2 diabetes mellitus (T2DM) patients with different renal function.

METHODS

A total of 85 T2DM patients were recruited in this study, all the patients were assigned to one group with estimated glomerular filtration rate (eGFR)≤60 ml·min·1.73 m and another group complicated with eGFR>60 ml·min·1.73 m. Serum creatinine, urine creatinine, serum fasting C-peptide (FCP), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1C) and 24-hour urinary C-peptide (24hUCP) were measured. The modified homeostasis model assessment-islet β cell function [HOMA-islet (CP-DM)], the modified homeostasis model assessment-insulin resistance [HOMA-IR(CP)] and UCPCR were calculated.

RESULTS

When compared with group eGFR ≤60 ml·min·1.73 m, the levels of UCPCR, FCP, the modified HOMA-IR(CP) and HOMA-islet (CP-DM) were promoted and the concentrations of HbA1C, FPG, creatinine were decreased in the patients of eGFR>60 ml·min·1.73 m (<0.05); FCP was uncorrelated with 24hUCP while associated with UCPCR in the patients of eGFR ≤ 60 ml·min·1.73 m; UCPCR was positively correlated with FCP and HOMA-IR(CP) in the T2DM patients with different levels of renal function; the cut-off (UCPCR ≤ 1.13 nmol/g) had 88.37% sensitivity and 95.24% specificity [95% confidence interval (CI):0.919-0.997] for identifying severe insulin deficiency in T2DM patients[area under the curve (AUC) 0.978].

CONCLUSION

UCPCR can be used to evaluate islets β Cell function in T2DM patients with different renal function status.

摘要

目的

本研究旨在探讨单次尿 C 肽/肌酐(UCPCR)在评估不同肾功能的 2 型糖尿病(T2DM)患者胰岛β细胞功能中的作用。

方法

本研究共纳入 85 例 T2DM 患者,所有患者均分为肾小球滤过率(eGFR)≤60ml·min·1.73m 组和 eGFR>60ml·min·1.73m 组。检测血清肌酐、尿肌酐、空腹血清 C 肽(FCP)、空腹血糖(FBG)、糖化血红蛋白(HbA1C)和 24 小时尿 C 肽(24hUCP),计算改良稳态模型评估胰岛β细胞功能[HOMA-β(CP-DM)]、改良稳态模型评估胰岛素抵抗[HOMA-IR(CP)]和 UCPCR。

结果

与 eGFR≤60ml·min·1.73m 组相比,eGFR>60ml·min·1.73m 组的 UCPCR、FCP、改良 HOMA-IR(CP)和 HOMA-β(CP-DM)水平升高,HbA1C、FPG、肌酐浓度降低(P<0.05);eGFR≤60ml·min·1.73m 组 FCP 与 24hUCP 不相关,与 UCPCR 相关;不同肾功能 T2DM 患者 UCPCR 与 FCP 和 HOMA-IR(CP)呈正相关;UCPCR 截断值(UCPCR≤1.13nmol/g)诊断 T2DM 患者严重胰岛素缺乏的灵敏度为 88.37%,特异度为 95.24%[95%置信区间(CI):0.919-0.997],曲线下面积(AUC)为 0.978。

结论

UCPCR 可用于评估不同肾功能 T2DM 患者的胰岛β细胞功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1ae/9712960/acfae10dcf10/fendo-13-1052794-g001.jpg

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