• 暨南大學(xué)附屬第二醫(yī)院 深圳市人民醫(yī)院體檢部（廣東深圳，518020）;

【摘要】 目的  探討老年糖尿病患者血清胱抑素C與血脂及高敏C反應(yīng)蛋白的關(guān)系。 方法  2008年5月-2009年10月糖尿病患者共141例，其中糖尿病合并癥組68例，單純糖尿病組73例；另選取對(duì)照組51例。對(duì)入選者的血清胱抑素C、血脂及高敏C反應(yīng)蛋白進(jìn)行分析。 結(jié)果  老年男女糖尿病合并癥組血清胱抑素C、高敏C反應(yīng)蛋白、總膽固醇、甘油三酯及低密度脂蛋白膽固醇最高、高密度脂蛋白膽固醇最低，與對(duì)照組比較有統(tǒng)計(jì)學(xué)意義（P lt;0.05）、與單純糖尿病組比較，無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。老年男女單純糖尿病組高敏C反應(yīng)蛋白、總膽固醇、甘油三酯高于對(duì)照組，組間比較，有統(tǒng)計(jì)學(xué)意義（P lt;0.05）。老年男女單純糖尿病組血清胱抑素C與對(duì)照組比較，無(wú)統(tǒng)率學(xué)意義（P gt;0.05）。老年女性單純糖尿病組低密度脂蛋白膽固醇與對(duì)照組比較，有統(tǒng)計(jì)學(xué)意義（P lt;0.05）。老年男性糖尿病二組與對(duì)照組血清胱抑素C低于老年女性糖尿病二組與對(duì)照組，組間比較，無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。老年男性糖尿病患者血清胱抑素C與高敏C反應(yīng)蛋白及血脂不相關(guān)。老年女性糖尿病合并癥組血清胱抑素C與空腹血糖正相關(guān)；單純糖尿病組血清胱抑素C與高密度脂蛋白膽固醇負(fù)相關(guān)、與低密度脂蛋白膽固醇正相關(guān)、與高敏C反應(yīng)蛋白不相關(guān)。 結(jié)論  老年糖尿病患者高脂、高糖及低度炎癥狀態(tài)下，血清胱抑素C水平較高。血脂對(duì)血清胱抑素C的影響可能存在性別差異。隨著動(dòng)脈粥樣硬化的加重，血清胱抑素C有升高趨勢(shì)。
【Abstract】 Objective  To investigate the relationship between serum cystatin C concentration and lipid, hs-C reactive protein in the elderly with diabetes. Methods  A total of 192 senile people form May 2008 to October 2009 were investigated. There were 141 patients with diabetes, in whom 68 were with cardiovascular and cor, cerebrovascular diseases, 73 were with diabetes only.There were 51 control subjects. The data of serum cystatin C, hs-CRP, TC, TG, HDL-C and LDL-C were analyzed. Results  Serum cystatin C of elderly men was lower than that in elderly women, but no signifcant correlation between them was found (P gt;0.05). Serum cystatin C, hs-CRP, TC, TG and LDL-C was higher, and HDL-C was lower in male and female diabetes subjects with cardiovascular and cor, cerebrovascullar diseases, than that in control subjects (P lt;0.05). Serum hs-CRP, TC and TG were higher in the elderly with diabetes only, than that in control subjects (P lt;0.05). LDL-C was higher in senile women with diabetes only, than that in female control subjects (P lt;0.05). Serum cystatin C with LDL-C in elderly women with diabetes only, with FPG in female diabetes subjects with cardiovascular and cor, cerebrovascular diseases had position correlation (P lt;0.05). No correlation were observed between serum cystatin C and hs-CRP in male and female diabetes subjects, and lipid in male diabetes subjects. Conclusions  We speculate that high serum lipid, high glucose and low level of inflammation may result in increasing of serum cystatin C in senily people with diabetes. The influence of serum lipid on serum cystatin C may be different in male and female senile people.Along with atherosclerotic aggravating, the level of serum cystatin C was increasing.

引用本文： 孫巖,廖淑萍. 老年糖尿病患者血清胱抑素C與血脂及高敏C反應(yīng)蛋白的關(guān)系. 華西醫(yī)學(xué), 2010, 25(8): 1509-1512. doi: 復(fù)制

1. Shi GP, Sukhova GK, Grubb A, et al. Cystatin C in human atherosclerosis and aortic aneurysms[J]. J Clin Invest, 1999, 104(9): 1191-1197.
2. Yetkin E, Acikqoz N, Sivri N, et al. Increased plasma levels of cystatin C and transforming growth factor-beta1 in patients with coronary artery ectasia: can there be a potential interaction between cystatin C and transforming growth factor-factor-beta1[J]. Coron Artery Dis, 2007, 18(3): 211-214.
3. Brown MS, Goldstein JL. A receptor-mediated pathway for cholesterol homeostasis [J]. Science, 1986, 232(4746): 34-47.
4. Toshima S, Hasegawa A, Kurabayashi M, et al. Circulating oxidized low density lipoprotein: a biochemical risk marker for coronary heart disease[J]. Arterioscler Thromb Vasc Biol, 2000, 20: 2243-2247.
5. Report of expert committee on the diagonsis and classification of diabetes mellitus[J]. Diabetes Care, 2002, 25(Suppl 1): 5-20.
6. 中國(guó)高血壓防治指南修訂委員會(huì). 中國(guó)高血壓防治指南(2005年修訂版)[J]. 高血壓雜志, 2005, 13(增刊): 241.
7. Uzun H, Ozmen Keles M, Ataman R, et al. Serum cystatin C level as a potentially good marker for impaired kidney function[J]. Clin Biochem, 2005, 38(9): 792-798.
8. Galteau MM, Guyon M, Gueguen R, et al. Determination of serum cystatinC: biological variation and reference values[J]. Clin Chem Lab Med, 2001, 39(9): 850-857.
9. Wilson PW, D’Agostino RB, Levy Daniel, et al. Prediction of Coronary Heart Disease Using Risk Factor Categories[J]. Circulation, 1998, 97(18): 1837-1847.
10. Luc G, Bard J, Lesueur C, et al. Plasma cystatin-C and development of coronary heart disease: The PRIME Study[J]. Atherosclerosis, 185(2): 375-380.
11. Ross R. Atherosclerosis-an inflammatory disease[J]. N Engl J Med, 1999, 340: 115-126.
12. Randers E, Erlandsen EJ. Serum cystatin C as an endogenous marker of the renal function: a riview[J]. Clin Chem Lab Med, 37(4): 389-395.
13. Dickinson DP, Zhao Y, Thiesse M, et al. Direct mapping of seven genes encoding human type 2 cystatins to a single site located at 20p11. 2[J]. Genomis, 1994, 24(1): 172-175.
14. Bostom AG, Bausserman L, Jacques PF, et al. Cystatin C as a determinant of fasting plasma total homocysteine levels in coronary artery disease patients with normal serum creatinine[J]. Arterioscler, Thromb Vasc Biol, 1999, 19(9): 2241-2244.
15. Page MK, Bukki J, Luppa P, et al. Clinical value of cystatin C determination [J]. Clinica Chimica Acta, 2000, 297(1-2): 67-72.
  1. 1. Shi GP, Sukhova GK, Grubb A, et al. Cystatin C in human atherosclerosis and aortic aneurysms[J]. J Clin Invest, 1999, 104(9): 1191-1197.
  2. 2. Yetkin E, Acikqoz N, Sivri N, et al. Increased plasma levels of cystatin C and transforming growth factor-beta1 in patients with coronary artery ectasia: can there be a potential interaction between cystatin C and transforming growth factor-factor-beta1[J]. Coron Artery Dis, 2007, 18(3): 211-214.
  3. 3. Brown MS, Goldstein JL. A receptor-mediated pathway for cholesterol homeostasis [J]. Science, 1986, 232(4746): 34-47.
  4. 4. Toshima S, Hasegawa A, Kurabayashi M, et al. Circulating oxidized low density lipoprotein: a biochemical risk marker for coronary heart disease[J]. Arterioscler Thromb Vasc Biol, 2000, 20: 2243-2247.
  5. 5. Report of expert committee on the diagonsis and classification of diabetes mellitus[J]. Diabetes Care, 2002, 25(Suppl 1): 5-20.
  6. 6. 中國(guó)高血壓防治指南修訂委員會(huì). 中國(guó)高血壓防治指南(2005年修訂版)[J]. 高血壓雜志, 2005, 13(增刊): 241.
  7. 7. Uzun H, Ozmen Keles M, Ataman R, et al. Serum cystatin C level as a potentially good marker for impaired kidney function[J]. Clin Biochem, 2005, 38(9): 792-798.
  8. 8. Galteau MM, Guyon M, Gueguen R, et al. Determination of serum cystatinC: biological variation and reference values[J]. Clin Chem Lab Med, 2001, 39(9): 850-857.
  9. 9. Wilson PW, D’Agostino RB, Levy Daniel, et al. Prediction of Coronary Heart Disease Using Risk Factor Categories[J]. Circulation, 1998, 97(18): 1837-1847.
  10. 10. Luc G, Bard J, Lesueur C, et al. Plasma cystatin-C and development of coronary heart disease: The PRIME Study[J]. Atherosclerosis, 185(2): 375-380.
  11. 11. Ross R. Atherosclerosis-an inflammatory disease[J]. N Engl J Med, 1999, 340: 115-126.
  12. 12. Randers E, Erlandsen EJ. Serum cystatin C as an endogenous marker of the renal function: a riview[J]. Clin Chem Lab Med, 37(4): 389-395.
  13. 13. Dickinson DP, Zhao Y, Thiesse M, et al. Direct mapping of seven genes encoding human type 2 cystatins to a single site located at 20p11. 2[J]. Genomis, 1994, 24(1): 172-175.
  14. 14. Bostom AG, Bausserman L, Jacques PF, et al. Cystatin C as a determinant of fasting plasma total homocysteine levels in coronary artery disease patients with normal serum creatinine[J]. Arterioscler, Thromb Vasc Biol, 1999, 19(9): 2241-2244.
  15. 15. Page MK, Bukki J, Luppa P, et al. Clinical value of cystatin C determination [J]. Clinica Chimica Acta, 2000, 297(1-2): 67-72.