标题：2型糖尿病大血管病变与血清胱抑素C及超氧化物歧化酶的相关性研究

      作者：陈广树，冯烈
    (暨南大学附属第一医院内分泌及代谢科室，广东 广州 510630)

      卷次： 2016年27卷18期

      【摘要】 目的 探讨 2型糖尿病(T2DM)大血管病变患者联合检测血清胱抑素C (Cys-C)与超氧化物歧化酶
(SOD)的临床价值。方法 将 2014年 1月至 2015年 12月在我院内分泌科住院的 947例 T2DM患者分为单纯
T2DM组434例和合并大血管病变T2DM+MVC组513例，另选取健康体检者400例作为正常对照组，收集各组受
检者的Cys-C、SOD等生化指标，分析Cys-C及 SOD与T2DM大血管病变的相关性。结果 T2DM组及T2DM+
MVC组患者的体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、Cys-C、血清肌酐(Scr)、血清尿酸(SUA)、空腹血糖
(FBG)、糖化血红蛋白(HbA1c)、低密度脂蛋白(LDL-C)、甘油三酯(TG)、胆固醇(TC)均高于对照组，SOD、估算肾小球
滤过率(eGFR)、高密度脂蛋白（HDL-C）均低于对照组，差异均有统计学意义(P<0.05)；T2DM+MVC组患者的病程、
BMI、SBP、射血分数(EF)、Cys-C、Scr、SUA、HbA1c、eGFR、TG、TC均高于T2DM组，SOD、HDL-C均低于T2DM组，
差异均有统计学意义(P<0.05)；T2DM患者的大血管病变与病程、SUA、Cys-C呈正相关(r=-2.954、1.241、4.225，P<
0.05)，与 SOD、eGFR呈负相关 (r=-3.145、-2.524，P<0.05)，Cys-C与 SOD呈负相关 (r=-2.424，P<0.05)；联合检测
Cys-C与SOD对T2DM+MVC诊断的价值：即Cys-C>1.35 mg/L且SOD<126 U/mL时，其敏感性为85.6%，特异性为
89.2%。结论 血清Cys-C及SOD水平与T2DM大血管病变的进程紧密相关，两者联合检测对于该病变的诊断有
重要意义，同时为该疾病的治疗提供一定的指导价值。

      【关键词】 2型糖尿病；大血管病变；血清胱抑素C；超氧化物歧化酶；相关性

      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2016）18—2959—04


Study on the correlation between macrovascular complications and superoxide dismutase, serum cystatin-C in
type 2 diabetes mellitus.
CHEN Guang-shu, FENG Lie. Department of Endocrine and Metabolic Diseases, the First
Affiliated Hospital of Ji'nan University, Guangzhou 510630, Guangdong, CHINA

【Abstract】 Objective To study the clinical value of combined detection of serum cystatin-C (Cys-C) and su-
peroxide dismutase (SOD) in type 2 diabetes mellitus (T2DM) patients with macrovascular complications. Methods A
total of 947 cases of T2DM patients in our hospital during January 2014 to December 2015 were divided into two
groups: T2DM without complications (T2DM group, n=434) and T2DM with macrovascular complications group
(T2DM+MVC group, n=513). Another 400 healthy subjects were selected as normal control group. The biochemical in-
dexes of the serum Cys-C, SOD were collected, and the correlations between Cys-C, SOD and T2DM with macrovascu-
lar complications were analyzed. Results The levels of body mass index (BMI), systolic blood pressure (SBP), diastol-
ic blood pressure (DBP), Cys-C, serum creatinine (Scr), serum uric acid (SUA), fasting blood-glucose (FBG), hemoglo-
bin A1c (HbA1c), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and total cholesterol (TC) in T2DM
group and T2DM+MVC group were significantly higher than those in normal control group, and the SOD, estimated glo-
merular filtration rate (eGFR), high density lipoprotein cholesterol (HDL-C) were significantly lower than those in nor-
mal control group, with statistically significant differences (P<0.05). The levels of duration, BMI, SBP, ejection fraction
(EF), Cys-C, Scr, SUA, HbA1c, eGFR, TG and TC in T2DM+MVC group were significantly higher than those in T2DM
group, and the SOD, HDL-C were significantly lower than those in T2DM group, with statistically significant differenc-
es (P<0.05). Diabetic macrovascular complications were positively correlated with duration, serum SUA and Cys-C
(r=-2.954, 1.241, 4.225, P<0.05), which were negatively correlated with SOD and eGFR (r=-3.145, -2.524, P<0.05).
The level of Cys-C was positively correlated with SOD (r=-2.424, P<0.05). For combined detection of Cys-C and SOD
in the diagnosis of T2DM with macrovascular complications, the sensitivity and the specificity was 85.6% and 89.2%, re-
spectively at Cys-C>1.35 mg/L and SOD<126 U/mL. Conclusion Serum Cys-C and SOD levels were closely related
to the macrovascular complications progression of T2DM, and the combined detection of both of them had important sig-
nificance in the diagnosis of the disease. It can provide some guidance value for the treatment of the disease.

      【Key words】 Type 2 diabetes mellitus (T2DM); Macrovascular complications; Serum cystatin-C (Cys-C); Super-
oxide dismutase (SOD); Correlation
·论 著·
6350.2016.18.012