Use of serum cystatin C to detect early decline of glomerular filtration rate in type 2 diabetes.
Use of serum cystatin C to detect early decline of glomerular filtration rate in type 2 diabetes.
复制标题
使用血清胱抑素 C 检测 2 型糖尿病肾小球滤过率的早期下降。
作者：
Yi;C. Peng;Chih;Chi;Chien
对象
血清半胱氨酸氨基转移酶C的测定及其在糖尿病患者肾小球滤过率(GFR)估计中的实际应用已被证实，然而，这些研究没有使用慢性肾脏疾病的GFR分期。因此，我们在2型糖尿病患者中进行了这项研究，目的是通过国家肾脏基金会定义的慢性肾脏疾病分期，检查血清胱抑素C在检测GFR早期下降方面的有用性。
方法
研究对象为中山医科大学医院收治的102例台湾2型糖尿病患者。取清晨空腹血样和尿样，测定基础代谢参数、血肌酐、血清胱抑素C和白蛋白/肌酐比值。用Cockcroft-Gault方程测定GFR。
结果
在102名2型糖尿病患者中，分别有67名、25名和10名患者有正常、微量和大量蛋白尿。血清半胱氨酸氨基转移酶C检测早期肾小球滤过率下降优于血肌酐。以Cg-Ccr为临界值分别为90ml/min和60ml/min时，血清半胱氨酸氨基转移酶C对慢性肾脏病1、2期的诊断准确率高于血肌酐。此外，血清胱抑素C还与尿白蛋白排泄量相关，而与血肌酐无关。
结论
这些结果提示，血清半胱氨酸氨基转移酶C可作为早期识别轻度肾功能减退的血清标志物，也可作为2型糖尿病早期肾小球功能障碍的标志物。
OBJECT
The estimation of serum cystatin C and its practical use for the estimation of the glomerular filtration rate (GFR) in diabetic patients has been previously demonstrated, however, those studies did not use the chronic kidney disease GFR staging. Therefore, we performed this study in type 2 diabetic patients with the aim to examine the usefulness of serum cystatin C to detect early decline of GFR using the staging of chronic kidney disease defined by the National Kidney Foundation.
METHODS
A total of 102 Taiwanese type 2 diabetic patients were recruited from the Chung-Shan Medical University Hospital. Morning fasting blood and urine samples were obtained for basal metabolic parameters, serum creatinine, serum cystatin C, and albumin-creatinine ratio. GFR was determined by Cockcroft-Gault equation creatinine clearance (CG-CCr).
RESULTS
Of the 102 type 2 diabetic patients, 67, 25, and 10 had normo-, micro-, and macroalbuminuria, respectively. Serum cystatin C was superior to serum creatinine in detecting early decline of GFR. The diagnostic accuracy of serum cystatin C was better than serum creatinine for stage 1 and 2 chronic kidney disease (CG-CCr cut-off value of 90 ml/min and 60 ml/min). Furthermore, serum cystatin C was also correlated with urine albumin excretion, which was not true with serum creatinine.
CONCLUSIONS
These results suggest that serum cystatin C may be an alternative serum marker for the early identification of subjects with a slight reduction of renal function, and also it may be a marker for early glomerular dysfunction in type 2 diabetes.
影响因子：
13.6
作者：
Perkins, BA;Nelson, RG;Warram, JH
通讯作者：
Warram, JH