Study Of Correlation Between Serum Cys-c, Hs-CRP, UA And Renal Microangiopathy In Patients With DN

Objective:To study the correlation between serum cyststine-C(Cys-c,C reactive protein,uric acid and renal microangiopathy in patients with diabetic nephropathy.Methods:All the research subjects were divided into four groups, such as the normal control group, merely DM without renal microangiopathy (DM), the patients with renal microangiopathy were divided into group microalbumin (DN1) and group macroalbumin (DN2) according to hours'urinary albumin excretion (UAER). Serum Cys C were determined by Particle-enhanced turbidimetric immunoassay (PETIA). Serum hs-CRP, UA, Serum creatine(Scr), blood urea nitrogen(BUN), blood lipid and urinary mALB were also measured for every subject. Meanwhile, glomerular filtration rate (GFR) measured by 99mTc-DTPA clearance was considered to be the Gold Standard. Correlation between GFR and serum Cys C, Scr, BUN was compared. Also, the correlation between CRP, UA, Cys-c and UAER was analyzed with multivariate linear regression analysis.Results:1. Compared with the normol control group, serum Cys-C, hs-CRP, UA in DM group and in groups with renal microangiopathy were significantly higher(P<0.05). And in DN1 group, DN2 group were higher than in the normal control group (P＜0.05), in DN2 group were higher than in DN1 group (P<0.05), the different--ces were significantly.2. Scr and BUN were significantly higher than in normal control group just in group DN2 (P＜0.05). There was no difference between DM and DN1. Scr and BUN were significantly higher than in DM group and in DN1 group in group DN2 (p＜0.05).GFR was significantly higher in group DM than in normal control group (P<0.05), while in group DN1 and DN2 were significantly lower than in normal control group (P＜0.05). GFR in three groups had significant differences(P＜0.05), in DM was higher than in DN1 and DN2, in DN1 was higher than in DN2.Compared with the normol control group, UAER were significantly higher in DM group and in groups with renal microangiopathy (P＜0.05). And higher in DN1 group,DN2 group than in the normal control group(P＜0.05), higher in DN2 group than in DN1 group(P<0.05), the differences were significantly.3. GFR was negatively correlated with serum Cys-C, Scr, BUN, the correlation coefficient were -0.481,-0.392, -0.384, and that of between GFR and serum Cys C was the most strongest.4. The significant correlation between serum Cys-c, hs-CRP, UA and renal microangiopdthy were found (P＜0.05), the coefficients of correlation were:0.351,0.638, 0.448. There was a positive correlation between thelevels of UA, Cys-c and hs-CRP.5. The regression analysis showed that:serum Cys-c, hs-CRP and UA were independent factors of renal microangiopdthy, from strong to weak:UA, hs-CRP, Cys-c.Conclusion:Serum Cys-c, hs-CRP and UA may participate in the development of renal microangiopathy through inflammatory mechanisms in diabetic nephropathy,become predictors of renal microangiopathy in DN.