论文部分内容阅读
目的研究尿蛋白正常或微量白蛋白尿的2型糖尿病患者胱抑素C(cystatin C,CY_(s-c))与无症状的外周动脉病(PAD)发生的关系。方法研究对象为2015年1月—2016年5月收治的160例2型糖尿病患者(T2DM)且所有研究对象的尿白蛋白排泄率(UAER)<300 mg/24 h。专业技师利用多普勒超声探头检测所有患者双侧的上臂和踝部(胫后动脉或足背动脉)的收缩压,分别取收缩压的最高值;若踝臂指数ABI≤0.9,判定为PAD。结果相比无PAD患者,PAD患者eGFR显著降低,UAER、血肌酐(Scr)和CY_(s-c)显著升高。CY_(s-c)与年龄,吸烟,HDL,eGFR以及PAD独立相关。CY_(s-c)、UAER、eGFR每增加1个SD,PAD风险比值分别为2.57(95%CI,1.67~3.80),1.76(95%CI,1.06~2.54)和0.47(95%CI,0.21~0.77);当校正年龄、性别、吸烟和高血压等因素后,仅CY_(s-c)的OR=1.72(1.20~2.78),有统计学意义(P<0.05)。结论 CY_(s-c)与尿蛋白正常或微量白蛋白尿的2型糖尿病患者PAD发生独立相关。
Objective To investigate the relationship between cystatin C (CY-s-c) and asymptomatic peripheral arterial disease (PAD) in type 2 diabetic patients with normal urinary albumin or microalbuminuria. Methods A total of 160 patients with type 2 diabetes mellitus (T2DM) admitted to our hospital from January 2015 to May 2016 were enrolled in this study. Urinary albumin excretion rate (UAER) was less than 300 mg / 24 h in all study participants. Professional technicians use the Doppler ultrasound probe to detect the systolic blood pressure of the upper arm and ankle (the posterior tibial artery or dorsalis pedis artery) on both sides of all patients, respectively, the highest value of systolic blood pressure; if ankle-brachial index ABI≤0.9, determined as PAD . Results Compared with patients without PAD, the eGFR of PAD patients was significantly lower and the levels of UAER, Scr and CY_ (s-c) were significantly increased. CY_ (s-c) was independently associated with age, smoking, HDL, eGFR, and PAD. The risk of PAD was 2.57 (95% CI, 1.67-3.80), 1.76 (95% CI, 1.06-2.54) and 0.47 (95% CI, 0.21-0.77) for each additional SD of CY sc, UAER and eGFR, ). Only OR = 1.72 (1.20-2.78) of CY_ (sc) after adjusting for age, gender, smoking and hypertension were statistically significant (P <0.05). Conclusion CY_ (s-c) is independently associated with PAD in type 2 diabetic patients with normal urine protein or microalbuminuria.