Correlation between cystatin C,α-klotho protein,sICAM-1 and diabetic nephropathy

doi:10.3969/j.issn.1673-8640.2020.10.015

Abstract

Abstract:

Objective To investigate the correlation between cystatin C（Cys C）,α-klotho protein,serum soluble intercellular adhesion molecule-1（sICAM -1） and diabetic nephropathy（DN）. Methods A total of 160 patients with type 2 diabetes mellitus（T2DM） were enrolled. The patients were classified into 2 groups according to urinary albumin to creatinine ratio（ACR）. There were 40 cases of simple T2DM group（ACR<30 mg/g）,60 cases of early DN group（ACR 30-300 mg/g） and 60 cases of clinical DN group（ACR>300 mg/g）. Totally,60 healthy subjects were enrolled as healthy control group. The levels of serum Cys C,α-klotho protein,sICAM-1 and kidney function indexes [serum creatinine（Cr）,uric acid（UA） and blood urea nitrogen（BUN）] were determined. Pearson correlation analysis was used to evaluate the correlation between Cys C,α-klotho protein,sICAM-1 and ACR. Receiver operating characteristic（ROC） curve analysis was used to evaluate the efficiency of early kidney injury in T2DM patients. Results Serum levels of Cys C,sICAM-1,Cr,UA and BUN in T2DM patients were higher than those in healthy control group（P<0.05）,and serum α-klotho protein was lower（P<0.05）. Cys C and sICAM-1 were increased with the progress of DN conditions（P<0.05）,and serum α-klotho protein was decreased with the severity of DN（P<0.05）. Cys C and sICAM-1 were positively correlated with ACR（r=0.562 and 0.613,respectively,P<0.05）,and serum α- Klotho protein was negatively correlated with ACR（r=-0.702,P<0.05）. ACR>30 mg/g was used as the criterion of early kidney injury in T2DM patients. The areas under curves（AUC） of Cys C,sICAM-1 and serum α-klotho protein for the diagnosis of early kidney injury in T2DM patients were 0.796,0.801 and 0.795,respectively. The optimal cut-off values were 1.39 mg/L,352.61 ng/mL and 531.95 pg/mL,the sensitivities were 73.75%,82.50% and 75.00%,and the specificities were 80.00%,68.33% and 76.67%,respectively. Conclusions Cys C,sICAM-1 and serum α-klotho protein play roles in the diagnosis of early kidney injury among T2DM patients.

Key words: Cystatin C, α-Klotho protein, Soluble intercellular adhesion molecule-1, Diabetic nephropathy

CLC Number:

R446.1

CHEN Jun. Correlation between cystatin C,α-klotho protein,sICAM-1 and diabetic nephropathy[J]. Laboratory Medicine, 2020, 35(10): 1032-1035.

Figures/Tables 3

References 13

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组别	例数	Cys C/ （mg/L）	sICAM-1/（ng/mL）	α-klotho蛋白/ （pg/mL）	Cr/ （μmol/L）	UA/ （μmol/L）	BUN/ （mmol/L）
T2DM组	160	1.5±0.6	312.4±72.5	582.6±83.4	109.4±31.5	324.6±59.7	6.3±1.5
正常对照组	60	0.6±0.5	250.1±50.7	765.7±212.5	92.1±17.6	196.2±31.5	4.2±0.8
t值		10.350	6.110	9.197	4.022	15.840	10.300
P值		0.000	0.000	0.000	0.000	0.000	0.000

组别	例数	Cys C/ （mg/L）	sICAM-1/（ng/mL）	α-klotho蛋白/ （pg/mL）	Cr/ （μmol/L）	UA/ （μmol/L）	BUN/ （mmol/L）
T2DM组	160	1.5±0.6	312.4±72.5	582.6±83.4	109.4±31.5	324.6±59.7	6.3±1.5
正常对照组	60	0.6±0.5	250.1±50.7	765.7±212.5	92.1±17.6	196.2±31.5	4.2±0.8
t值		10.350	6.110	9.197	4.022	15.840	10.300
P值		0.000	0.000	0.000	0.000	0.000	0.000

组别	例数	Cys C/ （mg/L）	sICAM-1/ （ng/mL）	α-klotho蛋白/ （pg/mL）	Cr/ （μmol/L）	UA/ （μmol/L）	BUN/ （mmol/L）
单纯T2DM组	40	0.9±0.2^*	291.3±56.1^*	672.3±89.9^*	93.4±16.5	192.6±49.7	4.3±0.5
早期DN组	60	1.3±0.5^*#	332.4±63.5^*#	581.3±73.5^*#	94.1±27.6	193.2±51.5	4.5±1.2
临床DN组	60	1.7±0.8^*#△	364.6±72.9^*#△	502.3±85.4^*#△	119.1±35.4^*#△	351.7±62.3^*#△	7.6±1.9^*#△
正常对照组	60	0.6±0.5	250.1±50.7	765.7±52.5	92.1±17.6	196.2±31.5	4.2±0.8
F值		50.780	38.240	134.801	41.410	144.600	97.940
P值		0.000	0.000	0.000	0.000	0.000	0.000

组别	例数	Cys C/ （mg/L）	sICAM-1/ （ng/mL）	α-klotho蛋白/ （pg/mL）	Cr/ （μmol/L）	UA/ （μmol/L）	BUN/ （mmol/L）
单纯T2DM组	40	0.9±0.2^*	291.3±56.1^*	672.3±89.9^*	93.4±16.5	192.6±49.7	4.3±0.5
早期DN组	60	1.3±0.5^*#	332.4±63.5^*#	581.3±73.5^*#	94.1±27.6	193.2±51.5	4.5±1.2
临床DN组	60	1.7±0.8^*#△	364.6±72.9^*#△	502.3±85.4^*#△	119.1±35.4^*#△	351.7±62.3^*#△	7.6±1.9^*#△
正常对照组	60	0.6±0.5	250.1±50.7	765.7±52.5	92.1±17.6	196.2±31.5	4.2±0.8
F值		50.780	38.240	134.801	41.410	144.600	97.940
P值		0.000	0.000	0.000	0.000	0.000	0.000

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