新医学Issue(3)：149-152,4.DOI:10.3969/g.issn.0253-9802.2015.03.004
比较血清半胱氨酸蛋白酶抑制剂 C 和肌酐对糖尿病肾损害的诊断效能
Comparison of diagnostic efficacy of cystatin C and creatinine in diabetic nephropathy
摘要
Abstract
Objective To statistically compare the clinical efficacy of cystatin C (CysC)and serum creatinine in the diagnosis of type 2 diabetic nephropathy.Methods The general data of 279 patients diag-nosed with type 2 diabetes mellitus were recorded.The GHbA1 c ,serum CysC,serum creatinine,urinary albu-min excretion rate (UAE)and glomerular filtration rate (GFR)were measured.All patients were divided into the normal,low and high urinary protein groups for stratified analysis.Spearman's rank correlation analysis was performed to analyze the correlation among serum creatinine,CysC and GFR.The receiver operating character-istic (ROC)curve was obtained to statistically compare the diagnostic efficacy of CysC,Scr and UAE in dia-betic nephropathy [GFR <60 ml/min· (1 .73 m2 )].The influencing factors of CysC were evaluated by mul-tiple linear regression analysis.Results Age,course of diseases,GHbA1 c ,CysC,serum creatinine and 24 h UAE significantly differed among the normal,low and high urinary protein groups (all P <0.05).Serum creat-inine was positively correlated with CysC (rs =0.862,P <0.001 ),whereas CysC and serum creatinine de-clined over the increases in GRF with negative correlation (rs-CysC =-0.81 6,rs-serum creatinine =-0.747,all P <0.001 ).CysC was more closely correlated with GRF compared with serum creatinine.The area under the ROC curve demonstrated that compared with serum creatinine,CysC was higher efficacious in diagnosing nephropa-thy [GFR <60 ml/min· (1 .73 m2 )]and had higher UAE (0.963 vs.0.929 vs.0.720,all P <0.001 ).The diagnostic cut-off point of CysC was 1 .1 8 mg/L with sensitivity and specificity,93.3% and 87.9%.The diagnostic cut-off point of serum creatinine was 78.9 μmol/L,with sensitivity and specificity 85.6% and 92.6%.Multiple linear regression analysis revealed that the influencing factors of CysC included blood uric acid,serum albumin,age and GHbA1 c ,especially the blood uric acid with the highest influence (partial re-gression coefficient =0.447).Conclusions Serum CysC is more efficacious in evaluating type 2 diabetic ne-phropathy [GFR <60 ml/min· (1 .73 m2 )]compared with serum creatinine.The evaluating efficacy of Cy-sC is probably reduced for diabetic patients with hyperuricemia.关键词
血清半胱氨酸蛋白酶抑制剂 C/血清肌酐/2 型糖尿病/肾小球滤过率Key words
Cystatin C/Serum creatinine/Type 2 diabetes mellitus/Glomerular filtration rate引用本文复制引用
陈宣蓉,林硕,王曼曼,曾龙驿..比较血清半胱氨酸蛋白酶抑制剂 C 和肌酐对糖尿病肾损害的诊断效能[J].新医学,2015,(3):149-152,4.基金项目
广东省自然科学基金项目 （）
