Clinical value of plasma Cys C,Hcy,sICAM-1 for early detection of diabetic nephropathy

Dong Xia; Han Rui; Yang Wei; Pang Wei

doi:10.13406/j.cnki.cyxb.000997

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Clinical value of plasma Cys C,Hcy,sICAM-1 for early detection of diabetic nephropathy

更新时间：2024-01-17

- Clinical value of plasma Cys C,Hcy,sICAM-1 for early detection of diabetic nephropathy
- Journal of Chongqing Medical University Vol. 41, Issue 11, Pages: 1142-1146(2016)
- 作者机构：
  
  昆明医科大学第一附属医院糖尿病科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.000997
  CLC： R587.2;R692.9
- Published：2016，
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[1]董霞,韩睿,杨薇,庞薇.血浆CysC、Hcy、sICAM-1对糖尿病肾病早期检测的临床价值[J].重庆医科大学学报,2016,41(11):1142-1146.

Dong Xia, Han Rui, Yang Wei, et al. Clinical value of plasma Cys C,Hcy,sICAM-1 for early detection of diabetic nephropathy. [J]. Journal of Chongqing Medical University 41(11):1142-1146(2016)
[1]董霞,韩睿,杨薇,庞薇.血浆CysC、Hcy、sICAM-1对糖尿病肾病早期检测的临床价值[J].重庆医科大学学报,2016,41(11):1142-1146. DOI： 10.13406/j.cnki.cyxb.000997.

Dong Xia, Han Rui, Yang Wei, et al. Clinical value of plasma Cys C,Hcy,sICAM-1 for early detection of diabetic nephropathy. [J]. Journal of Chongqing Medical University 41(11):1142-1146(2016) DOI： 10.13406/j.cnki.cyxb.000997.

摘要

目的:研究同型半胱氨酸（homocysteine

Hcy）、胱抑素C（cystatin C

CysC）、可溶性细胞间粘附分子-1（soluble intercellular adhesion molecule-1

s ICAM-1）在2型糖尿病及糖尿病肾病（diabetic nephropathy

DN）患者血浆中的水平变化

探讨联合检测敏感性对DN早期的意义。方法:以尿微量白蛋白肌酐比值（urinary albumin creatinine ratio

UACR）为DN诊断标准

将180例2型糖尿病受试者分为糖尿病非肾病组（NDN组）和糖尿病肾病（DN组）

以90例正常人作为对照组（NC组）

比较3组间Hcy、CysC、s ICAM-1水平的差异

以及与UACR的关系。以NDN组、DN组作ROC曲线

计算三者单独检测及联合检测的敏感性及特异性。结果:1DN组Hcy、CysC、s ICAM-1和UACR水平均高于NC组

差异有统计学意义（P值均为0.000）

且高于NDN组（P值均为0.000）;NDN组Hcy、CysC水平高于NC组（P值均为0.000）

s ICAM-1在两组间未见统计学差异（P=0.153）;2DN组Hcy、CysC、s ICAM-1敏感性分别为81.11%、56.7%、10%

特异度分别为47.7%、77.8%、97.7%

联合检测敏感性为88.8%

各指标ROC曲线下面积分别为0.74、0.78、0.72

95%CI分别为0.667

.816、0.707

.843、0.640

.794

P值均为0.000

联合检测ROC曲线下面积为0.813

95%CI=0.748

.878;3Hcy、CysC、s ICAM-1水平与UACR呈正相关（r值分别为0.028、0.449、0.164

P值分别为0.001、0.000、0.047）。结论:DN早期Hcy、CysC、s ICAM-1已异常升高

且与UACR呈正相关关系

三者联合检测可提高DN早期检出率。

Abstract

Objective:To explore the significance of combined detection of cystatin C(CysC)

homocysteine(Hcy)

soluble intercellular adhesion molecule-1(s ICAM-1)in the early detection of diabetic nephropathy(DN). Methods:According to urinary albumin creatinine ratio(UACR)

180 diabetic cases were divided into non-diabetic nephropathy group(NDN) and diabetic nephropathy group(DN)

and 90 normal persons were taken as the control(NC). The levels of Hcy

CysC

s ICAM-1 in the three groups were detected

and their relationship with UACR was observed. The ROC curve was drawn and its sensitivity and specificity was calculated. Results:(1)Hcy

CysC

s ICAM-1 and UACR levels were higher in group DN than in group NC and group NDN

with statistically significant differences(P1=0.000

P2=0.000

P3=0.000

P4=0.000). Hcy and CysC levels were higher in group NDN than in group NC(P1=0.000

P2=0.000

P3=0.000

P4=0.000)

and there was no statistical difference in s ICAM-1 between the two groups(P=0.153).(2)In group DN

the sensitivity rates of Hcy

CysC

s ICAM-1 were 81.11%

56.7%

10% respectively;the specificity rates were 47.7%

77.8%

97.7%

38.89%

97.7%;the area under the ROC curve of each index were 0.74

0.78

0.72(P1=0.000

P2=0.000

P3=0.000);95%CI were0.667-0.816

0.707-0.843

0.640-0.794 respectively. For joint detection

the sensitivity was 88.8%

the area under the ROC curve was 0.813

95% CI was 0.748-0.878.(3)Hcy

CysC

s ICAM-1 was positively correlated with UACR(r were 0.028

0.449

0.164 respectively

P1=0.001

P2=0.000

P3=0.047). Conclusion:Hcy

CysC

s ICAM-1 can be detected at early stage of diabetic nephropathy

and are positively correlated with UACR. Combined detection of the three can improve the early detection rate of DN.

关键词

糖尿病肾病同型半胱氨酸半胱氨酸蛋白酶抑制剂细胞间粘附分子-1尿微量白蛋白早期诊断

Keywords

diabetic nephropathieshomocysteinecystatin CIntercellular adhesion molecule-1microalbuminuriaearly diagnosis

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