老年代谢综合征人群胱抑素C浓度研究

doi:10.3969/j.issn.1006-7795.2017.04.010

摘要/Abstract

摘要： 目的探讨老年代谢综合征（metabolic syndrome，MS）人群胱抑素C（cystatin C，Cys C）浓度及其与MS主要组分及胰岛素敏感指数（homeostasis model assessment of insulin resistance，HOMA-IR）之间的关系。方法参加体检的404例老年人（>60岁）及60例无MS组分的非老年人（≤ 60岁）纳入本研究，测定MS主要组分、空腹胰岛素（fasting insulin，FINS）、Cys C、血清肌酐（serum creatinine，SCr）等指标；按MS诊断标准将老年人群分为MS组与非MS组，进一步按MS组分分组，分析不同组间Cys C差异及其与MS组分间的关系。结果研究人群Cys C性别差异无统计学意义（P>0.05），MS组Cys C浓度显著高于非MS组（1.10±0.25 vs 1.02±0.25，P<0.01），随着研究人群含有MS组分的增多，Cys C显著增高（P<0.05），其灵敏度优于SCr及估算肾小球滤过率（estimated glomerular filtration rate，eGFR）；多元逐步回归分析表明体质量指数（body mass index，BMI）、三酰甘油（triglyceride，TG）、HOMA-IR是Cys C独立影响因素。结论随着研究人群MS组分数增加，Cys C显著上升，可作为老年MS人群早期肾功能损伤及心血管疾病（cardiovascular disease，CVD）危险性评估的指标。

关键词: 代谢综合征, 胱抑素C, 早期肾功能损伤

Abstract: Objective To investigate the change of serum cystatin C level and its relationship with metabolic syndrome (MS) main components and homeostasis model assessment of insulin resistance (HOMA-IR) in elderly population with MS. Methods A total of 404 Beijing elderly inhabitants (>60 years, age ranged 60-88 years) and 60 control persons (≤60 years, age ranged 35-60 years) without MS components were enrolled into the present study, and the data including MS components, fasting insulin (FINS), serum creatinine (SCr) and cystatin C were tested and some parameters such as HOMA-IR and estimated glomerular filtration rate (eGFR) were measured; according to MS criteria defined by Chinese Diabetes Society, the elderly subjects were divided in to MS and non-MS, and the groups with abnormal MS components, respecitively. Results Cystatin C indicated no significant differences between male and female(P>0.05), and higher in MS than in non-MS(1.10±0.25 vs 1.02±0.25, P<0.01). Furthermore, with the graded increase of MS components, serum cystatin C showed a progressive rise, with its sensitivity higher than that of SCr and eGFR; In addition, the multiple regression (Stepwise method) showed that the body mass index (BMI), triglyceride (TG) and HOMA-IR were also the independent influencing factors of serum cystatin C. Conclusion With the deterioration of the metabolic abnormality of the study population, serum cystatin C showed an increasing tendency and it may be taken as a screening marker of early nephropathy and a predicting index of cardiovascular disease (CVD) in MS population.

Key words: metabolic syndrome, cystatin C, early nephropathy

中图分类号:

R589

张鲲, 张婵媛, 陈剑, 鲁炳怀. 老年代谢综合征人群胱抑素C浓度研究[J]. 首都医科大学学报, 2017, 38(4): 535-540.

Zhang Kun, Zhang Chanyuan, Chen Jian, Lu Binghuai. Study on the serum cystatin C in the elderly population with metabolic syndrome[J]. Journal of Capital Medical University, 2017, 38(4): 535-540.

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