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Objective:To detect the plasma concentration of P-selectin and the serum concentration of cystatin C in type 2 diabetic patients and explore the roles of them in the early prediction of diabetic nephropathy.Methods:(1) Shanxi Provincial People’s Hospital endocrinology department hospital patients with type 2 diabetes 125 cases from April to July in 2009 years,,67 cases of male,58 cases of female, aged 42-73 years old. Gathered general information on patients, Detected fasting serum cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), glycated hemoglobin (HbAlC), serum creatinine (SCr), plasma P-selectin (P-s), cystatin C (Cys-C) and urine microalbumin/urine creatinine. Collecd 24-hour urine of three days, then recorded the average, calculate the value of endogenous creatinine clearance rate (Ccr). Acorrding to 2007 Chinese type 2 diabetes prevention and treatment guidelines, using urine albumin/urine creatinine as the code of subgroup, the patients are divided into three groups: the normal albuminuria group,47 cases, the microalbuminuria group,42 cases and the massive albuminuria group,36 cases, used the Concentration of P-s as the dependent variable (Y), and course of disease (X,), BMI (X2), HbAlC (X3), TC (X4), TG (X5), LDL (X6), HDL (X7) as independent variables to do the multiple linear regression analysis, used stepwise regression method to establish a multiple linear regression equation to explore the influencing factors of P-s.(2) Made the correlation analysis between Cys-C and P-s. (3) Made the correlation analysis between Cys-C and Ccr. If the urine albumin/urine creatinine M:0-22mg/g F:0-31 mg/g was used as a threshold, the patients could to be divided into normal and abnormal groups, using the reference value upper limit of Cys-C 1.03mg/L, the reference value lower limit of Ccr 80ml/min as train spacing point respectively, then measured the sensitivity and specificity of the two markers to reflect early renal dysfunction in patients with type 2 diabetes.Results:1 With the increase of urine albumin/urine creatinine, plasma concentration of P-s increased gradually, the differences among the groups had statistical significance (P<0.001). P-s had positive correlation with course of disease, BMI, LDL, TC, Scr, HbAlC and Cys-C (P<0.001), and had negative correlation with HDL Ccr (P<0.001), and had no significant correlation with age, TG (P>0.05).2 Finally, the course of the disease (X1), LDL (X6),and HDL(X7) entered into the equation (Y=48.873+22.284 X6+1.855 X1-0.168 X7))3 There was positive correlation between Cys-C and P-s with statistical significance, (r =0.826, P<0.001).4 The sensitivity of Cys-C to determine early renal dysfunction in patients with type 2 diabetes was 68.4% and the specificity was 93.1%; Ccr:the sensitivity was 61.7%. the specificity was 88.7%.Conclusion:1 P-s has correlation with the occurrence and development of diabetic nephropathy.2 There are closely correlation among P-s and the disorders of glucose metabolism, lipid metabolism.3 Comparing with Ccr, Cys-C has a higher sensitivity and specificity in judging the early renal dysfunction in patients with type 2 diabetes4 The detection of P-s and Cys-C has important clinical significance in the early diagnosis of diabetic nephropathy.
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