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目的本研究主要探讨尿肾损伤分子-1(KIM-1)及血胱蛋白酶抑制剂C(Cystatin C)对早期糖尿病肾病的诊断价值及糖尿病肾病发展的预测价值。方法选取我院内分泌科住院2型糖尿病患者118例,依据尿微量白蛋白/肌酐比值(UACR)将糖尿病患者分为糖尿病对照组、糖尿病微量白蛋白尿组以及糖尿病大量蛋白尿组,同期健康体检者41例作为正常对照组。收集各组清晨清洁中段尿,应用酶联免疫吸附法检测各组中尿KIM-1浓度。血清中Cystatin C浓度采用乳胶增强免疫比浊法进行检测。结果尿KIM-1在糖尿病各组中浓度明显高于正常对照组(P<0.05),但糖尿病各组间比较,差异无统计学意义;血Cystatin C水平在糖尿病各组中明显高于正常对照组,且随着尿蛋白的增加而逐渐升高。糖尿病患者尿KIM-1与血Cystatin C均与UACR呈正相关(r=0.427、0.726,P<0.01),与eGFR呈负相关(r=-0.008、-0.791,仅血Cystatin C的P<0.05)。结论尿KIM-1对糖尿病尿蛋白出现之前的早期肾损伤具有一定预测价值;血Cystatin C不仅可作为早期糖尿病肾病的诊断标准,同时对糖尿病肾病损伤程度具有一定预测价值。
Objective This study was aimed to investigate the diagnostic value of urinary renal injury molecule-1 (KIM-1) and serum cystatin C in the early stage of diabetic nephropathy and the prediction of the development of diabetic nephropathy. Methods A total of 118 type 2 diabetic inpatients with endocrinology in our hospital were enrolled. According to the urinary albumin / creatinine ratio (UACR), diabetic patients were divided into diabetic control group, diabetic microalbuminuria group and diabetic macroalbuminuria group. 41 cases as normal control group. Urine was collected in the early morning of each group. Urinary KIM-1 concentration in each group was detected by enzyme-linked immunosorbent assay. Serum Cystatin C concentration by latex enhanced turbidimetric assay. Results Urine KIM-1 in diabetic group was significantly higher than that in normal control group (P <0.05), but there was no significant difference between diabetic groups. The level of serum Cystatin C in diabetic patients was significantly higher than that in normal controls Group, and gradually increased with the increase of urinary protein. Urinary KIM-1 and serum Cystatin C were positively correlated with UACR in diabetic patients (r = 0.427,0.726, P <0.01) and negatively correlated with eGFR (r = -0.008, -0.791, P <0.05 only in blood Cystatin C) . Conclusions Urinary KIM-1 has some predictive value for the early renal injury of diabetic urine protein. Cystatin C can not only be used as a diagnostic criterion for early diabetic nephropathy, but also has a certain predictive value for the degree of diabetic nephropathy.