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| The application value of serum Cystatinc and Beta2-microglobulin for diagnosing early diabetic nephropathy |
| LI Rui, NIU Xiaochun, WANG Qingfen |
| Department of Nephrology,the People's Hospital of Binzhou,Binzhou 256600,P.R.China |
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Abstract Objective To investigate the diagnostic value of serum cystatinC(CysC) and β2-microglobulin(β2-MG) in early diabetic nephropathy.Methods Serum concentrations of cystatinC and β2-microglo-bulin were measured in 106 diabetes mellitus patients and 30 healthy people(group N)using immune turbidimetry method,which were also compared with serum creatinine (Scr),endogenous creatinine clearance (Ccr) and other related indicators.Patients were divided according to the urine albumin excretion rate (UAER) into normal albuminuria (Group A),microalbuminuria (Group B), and macroalbuminuria (Group C).The sensitivity and correlation in diabetic neuropathy (DN) diagnosis between serum CysC、β2-MG、Scr、Ccr concentrations were also respectively compared.Results 1.According to the UAER and compared with group N,CysC and β2-MG in group A have begun to increase while the creatinine started to increase in group C.Ccr increased in group A, while it declined in group C,but no obvious change in group B.All changes were statistically significant. 2.The sensitivity of serum CysC,β2-MG or Ccr were 53.77%,41.51%,31.13%;specificity of these three markers were 83.33%,66.67%,80.00%;and the accuracy were 60.29%,47.06% 41.91%.The sensitivity,specificity and accuracy of serum CysC are all higher than the other two.3.Serum CysC,β2-MG or Ccr is well correlated with UAER(r=0.884、0.756、-0.700,respectively).Scr is middle correlated with it(r=0.421,respectively).CysC、β2-MG is also correlated with Scr(r=0.470、0.458,respectively) and Ccr (r=-0.613、-0.559,respectively).CysC correlated more strongly with UAER (P＜0.01).4.Serum CysC,β2-MG,Ccr or Scr is well correlated with the diabetic nephropathy (＞20 g/min, according to UAER diagnostic criteria) (r=0.814、0.785、-0.780、0.520,P＜0.01).Among them,cystatinC correlated more strongly with diabetic nephropathy (P＜0.01).Conclusion The cystatinC and β2-microglobulin are important biochemical markers of early kidney damage of the type 2 diabetes patients.They are more sensitive and accurate than serum creatinine and endogenous creatinine clearance.Of these two markers,cystatinC has better diagnostic value.
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Received: 31 May 2017
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[1] Bernier G M.beta 2-Microglobulin: structure,function and significance[J].Vox Sang,1980,38(6):323-327.
[2] Bianchi C,Donadio C,Tramonti G,et al.Reappraisal of serum beta2-microglo-bulin as marker of GFR[J].Ren Fail,2001,23(3-4):419-429.
[3] Dickinson DP.Salivary(SD2-type)cystatins: over one billion years in the making-but towhat purpose?[J].Crit Rev Oral Biol & Med,2002,13(6):485-508.
[4] Filler G, B kenkamp A,Hofmann W,et al.Cystatin C as a marker of GFR--history,indications,and future research[J].Clin Biochem,2005,38(1):1-8.
[5] Stabuc B,Vrhovec L,Stabuc-Silih M,et al.Improved prediction of decreased creatinine clearance by serum cystatin C:use in cancer patients before and during chemotherapy[J].Clin Chem,2000,46(2):193-197.
[6] Jacobsson B,Lignelid H, Bergerheim USR.Transthyretin and cystatin C are catabolized in proximal tubular epithelial cells and the proteins are not useful as markers for renal cell carcinomas[J].Histopathology,2010,26(6):559-564.
[7] Filler G,B kenkamp A,Hofnann W,et al.Cystatin C as a marker of GFR--history, indications,and future research[J].Clin Biochem,2005,38(1):1-8. |
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