胱抑素 C 在检测亚洲 2 型糖尿病患者并发威胁视力的糖尿病视网膜病变中的作用。

Role of cystatin C in the detection of sight-threatening diabetic retinopathy in Asian Indians with type 2 diabetes.

机构信息

Department of Research Operations and Diabetes Complications, Madras Diabetes Research Foundation, Chennai, India.

NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK; Vision Sciences, UCL Institute of Ophthalmology, London, UK.

出版信息

J Diabetes Complications. 2023 Aug;37(8):108545. doi: 10.1016/j.jdiacomp.2023.108545. Epub 2023 Jun 15.

DOI:10.1016/j.jdiacomp.2023.108545

PMID:37348180

Abstract

AIM

To study the association between cystatin C and sight-threatening diabetic retinopathy (STDR) in Asian Indians with type 2 diabetes (T2DM).

METHODS

In a cross-sectional study carried out at two tertiary centres in India in 2022, individuals with T2DM underwent clinical and ophthalmic assessments and estimation of serum cystatin C. Grading of DR was done by retina specialists. STDR was defined by the presence of severe non-proliferative DR (NPDR), proliferative DR (PDR) and/or diabetic macular edema. Receiver operating characteristic (ROC) curves were used to identify cystatin C cut-off value for detecting STDR.

RESULTS

Among 420 individuals with T2DM (mean age 56 ± 9 years; mean duration of diabetes 14.5 ± 7.9 years), 121 (24.1 %) had No-DR, 119 (28.3 %) had No-STDR and 200 (49.6 %) had STDR. Mean cystatin C level was significantly higher in individuals with STDR compared to those with no-STDR and No-DR (1.34 vs 1.06 vs 0.93 mg/L, p < 0.001). Cystatin C cut-off value ≥1.11 mg/L had a C statistic of 0.944 (95 % CI: 0.909-0.968, p < 0.001), 96.8 % sensitivity and 78.2 % specificity for detection of STDR.

CONCLUSION

Elevated serum cystatin C was strongly associated with STDR and could possibly be used as a biomarker for screening for sight-threatening diabetic retinopathy.

摘要

目的

研究胱抑素 C 与亚洲 2 型糖尿病患者视力威胁性糖尿病视网膜病变（STDR）之间的关系。

方法

在 2022 年印度的两个三级中心进行的横断面研究中，2 型糖尿病患者接受了临床和眼科评估以及血清胱抑素 C 的测定。DR 的分级由视网膜专家进行。将严重非增殖性 DR（NPDR）、增殖性 DR（PDR）和/或糖尿病性黄斑水肿的存在定义为 STDR。使用受试者工作特征（ROC）曲线确定用于检测 STDR 的胱抑素 C 截断值。

结果

在 420 名 2 型糖尿病患者（平均年龄 56 ± 9 岁；糖尿病平均病程 14.5 ± 7.9 年）中，121 名（24.1%）无 DR，119 名（28.3%）无 STDR，200 名（49.6%）有 STDR。与无 STDR 和无 DR 相比，STDR 患者的胱抑素 C 水平显著更高（1.34 vs 1.06 vs 0.93 mg/L，p < 0.001）。胱抑素 C 截断值≥1.11mg/L 的 C 统计量为 0.944（95%CI：0.909-0.968，p < 0.001），对 STDR 的检测具有 96.8%的敏感性和 78.2%的特异性。