| Objective To investigate the significance of serum cystatin C(Cys-C)andβ2-microglobulin(β2-MG)in early renal damage in patients with type 2 diabetes mellitus(T2DM).For the purpose of providing reference for the diagnosis of early diabetic kidney disease(DKD).Methods A total of 1004 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology of the Third Affiliated Hospital of Bengbu Medical College from October 2019 to September 2020 were selected as the subjects of this study.All patients were divided into three groups according to the urine microalbuminuria creatinine ratio(UACR).740 cases were divided into normal albuminuria group(NA group).172 cases were divided into microalbuminuria group(MA group).92 cases were divided into massive albuminuria group(LA group).The differences of basic data among the three groups such as the course of disease,body mass index(BMI),age,and gender were compared.The differences among the three groups in serum such as β2-MG,Cys-C,creatinine(Scr),urea nitrogen(BUN),glycosylated hemoglobin(Hb A1c)and fasting plasma glucose(FPG)were compared.Then we compared the correlations between UACR and the above data respectively.At the same time,we used the ROC curve to evaluate the significance of β2-MG,Cys-C,Scr and BUN in the diagnosis of DKD.P<0.05 indicates that the difference is statistically significant.Results 1.Basic information of the three groups: There was no significant difference in gender and BMI among NA,MA and LA groups(P > 0.05).The age of LA group was higher than that of NA group(P < 0.05).The course of disease in NA group,MA group and LA group increased gradually(P < 0.05).2.Serum indicators of the three groups: There was no significant difference in FPG among NA,MA and LA groups(P > 0.05).The level of Hb A1 c in MA group was higher than that in NA group(P < 0.05).The levels of β2-mg,Cys-C,Scr and BUN in NA group,MA group and LA group increased gradually(P < 0.05).3.Correlation between serum indexes and UACR: serum β2-MG,Cys-C,SCr,BUN and Hb A1 c were positively correlated with UACR(r values are 0.255,0.354,0.178,0.147,0.074,respectively)(P<0.05).There was no correlation between FPG and UACR(P>0.05).4.The correlation between basic data and UACR : age,course of disease,BMI and UACR were positively correlated(r values are 0.084,0.197,0.076,respectively)(P<0.05).5.ROC curve:Serum β2-MG and Cys-C were of great value in the diagnosis of early DKD.The area under the curve of serum Cys-C was 0.700,while 1.105mg/l was the optimal cut-off point for the diagnosis of early DKD(sensitivity and specificity were 45.45% and 86.89%,respectively).The area under the curve of serum β2-MG was 0.700,while 1.795mg/l was the optimal cut-off point for the diagnosis of early DKD(sensitivity and specificity were 54.92% and 80.40%,respectively).The difference of serum Cys-C and β2-Mg with BUN and Scr AUC was statistically significant(P<0.05).Conclusion 1.This study shows that the occurrence and development of DKD may be related to age,course of disease,Scr,BUN,Cys-C,β2-MG,and the control of plasma glucose.With the aggravation of renal damage,serum Scr,BUN,Cys-C,and β2-MG levels in T2 DM patients also increase.In particular,Cys-C and β2-MG have a good correlation with UACR,which is of great significance to the early diagnosis,treatment and condition monitoring of DKD.2.This study shows that the value of serum β2-MG and Cys-C in the diagnosis of early DKD is higher than that of BUN and Scr.3.This study shows that when the serum Cys-C concentration is 1.105 mg/L,it may be the cut-off value for the diagnosis of DKD.When the serum β2-MG concentration is 1.795 mg/L,it may be the critical value for diagnosing early DKD.Cys-C and β2-MG play a certain reference value for the diagnosis of early DKD. |
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