监测1型糖尿病肾功能下降Cystatin C比肌酐更精确

Serial Measurements of Cystatin C are More Accurate than Creatinine-based Methods in Detecting Declining Renal Function in Type 1 Diabetes
ABSTRACT
摘要

Objective: Cystatin C and creatinine-based methods were compared with 99mTc-DTPA plasma clearance (isotopic Glomerular Filtration Rate or iGFR) for detecting declining renal function.
目的：比较Cystatin C、肌酐和99mTc-DTPA 胞浆清除率(同位素肾小球率过滤，iGFR)监测肾功能的方法。

Research Design and Methods: GFR was monitored over a mean of 10.1 years in 85 subjects with type 1 diabetes (average of 5.6 measurements per individual). Baseline mean iGFR of the cohort was 106.1+2.6ml/min/1.73m2. The rates of decline in GFR (GFR) were derived using linear regression.
实验设计与方法：用GFR来监测85例1型糖尿病患者10.1年以上（平均每个人监测5.6次）。iGFR的基线是106.1+2.6ml/min/1.73m2。用线性回归来得出其GFR的下降率。

Results: In the 19/85 subjects with declining renal function (i.e. iGFR>3.3ml/min/1.73m2 per year), GFR (ml/min/1.73m2 per year) was: 6.5 by iGFR and 4.2 by 104/creatinine, 3.6 by Cockcroft-Gault formula, 3.4 by MDRD-6 -equation and 3.5 by MDRD-4 variable-equation (p<0.01 versus iGFR). In comparison, GFR was 6.1 using the formula Cys-GFR=(86.7/cystatin C concentration)–4.2 (ns).
结果：85例患者中有19人肾功能下降(例如每年 iGFR>3.3ml/min/1.73m2 ), GFR(ml/min/1.73m2/年)定义为：用iGFR的方法是6.5，用104/肌酐的方法是4.2，用Cockcroft-Gault 公式是3.6，用MDRD-6-方程式是3.4，用MDRD-4-方程式是3.5(以iGFR为对照p<0.01 ). 而用公式Cys-GFR=(86.7/cystatin C 浓度)–4.2 (ns).就是6.1。

Conclusions: Cystatin C was more accurate in detecting decline in renal function than creatinine-based methods in this population of subjects with Type 1 and a normal mean baseline GFR.
结论：Cystatin C监测1型糖尿病人群肾功能的下降和预算正常GFR基线比肌酐更精确。