| Objective: To explore the significance of renal artery resistance index and serum cystatin C in the diagnosis of early diabetic kidney disease by measuring and comparing serum cystatin C and renal artery resistance index in patients with early diabetic kidney disease.Methods:We invited 183 people to participate in this study,among them,there were 47 healthy people in one group,it were called the control group;The rest of the participants were divided into two groups,one was simple type 2 diabetes mellitus group,there were 71 type 2 diabetes mellitus patients,another was microalbuminuria group,there were 65 early diabetic kidney disease patients.Diagnostic criteriains are accordance with the diagnostic standard of diabetes mellitus in Chinameeting and the ADA diagnostic criteria of early diabetic kidney disease.In this study,we will collected general data and biochemical index of participants,and GFR was calculated by CKD-EPI formula.Spss19.0 statistical software was used for comparative analysis and ROC curve prediction.Results:1.ACR,Cys C,HbAlc,UA and TG in type 2 diabetes mellitus with microalbuminuria group were higher than those in simple type 2 diabetes mellitus group and healthy control group(p< 0.05).2.The RI of renal aorta,renal segmental artery and interlobar artery in type 2 diabetes mellitus with microalbuminuria group were higher than those in simple type 2 diabetes mellitus group,and the RI in simple type 2 diabetes mellitus group was higher than that in control group(p <0.05).3.There were differences in BMI and course of disease among the three groups(p < 0.05).4.Serum Cys C was positively correlated with RI of renal aorta(r =0.43,p< 0.01),renal segmental artery RI(r = 0.55,p < 0.01),and renal interlobar artery RI(r = 0.61,p < 0.01);ACR was positively correlated with RI of renal aorta(r= 0.34,p < 0.01),RI of renal segmental artery(r = 0.59,p <0.01),RI of renal interlobar artery(r = 0.66,p < 0.01)and serum Cys C(r = 0.71,p <0.01).5.ACR(30-300 mg / g)was used as the diagnostic criteria for microalbuminuria in type 2diabetes mellitus,ROC curve was used to evaluate RI of renal artery and serum Cys C to predict microalbuminuria in type 2 diabetes mellitus,the best cut-off value of renal aorta RI in early diagnosis of diabetic kidney disease was 0.725,the area under curve was 0.740,the Youden index was 0.390,the sensitivity was 61.5%,and the specificity was 77.5%(p < 0.01,95% confidence interval: 0.657-0.824);the best cut-off value of renal segmental artery RI in early diagnosis of diabetic kidney disease was 0.695,area under curve was 0.663,yoden index was 0.308,sensitivity was 64.6%,specificity was66.2%,(p < 0.01,95% confidence interval: 0.570-0.756).The best cut-off value of renal interlobar artery RI in early diagnosis of diabetic kidney disease was 0.655,area under curve was 0.848,Youden index was 0.583,sensitivity was 73.8%,specificity was 84.5%(p < 0.01,95% confidence interval: 0.785-0.912).The best cut-off value of serum Cys C in the early diagnosis of diabetic kidney disease was 0.975,the area under the curve was 0.739,the Youden index was 0.3881,the sensitivity was 67.7%,and the specificity was 70.4%(p < 0.01,95% confidence interval: 0.656-0.821).Diagnosis of early diabetic kidney disease by renal interlobar artery RI combined with serum Cys C,the area under the curve of diabetic kidney disease was 0.864,Youden index was 0.644,sensitivity was 78.5%,specificity was 85.9%(p < 0.01,95%confidence interval: 0.802-0.926).Conclusion:1.With the appearance of microalbuminuria in patients with type 2 diabetes mellitus,Cys C,UA,HbAlc,RRI and other indicators in serum increased.2.There was a positive correlation between serum Cys C and RRI.3.Serum Cys C combined with renal interlobar artery RI examination has a certain clinical value in the evaluation of early diabetic kidney disease. |
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