生物谷綜合： 一種稱為血清半胱氨酸蛋白酶抑制物C（cystatin C）的血液組分常用來診斷早期腎臟損傷，但Buffalo大學(xué)進(jìn)行的研究結(jié)果顯示,，cystatin C同樣是預(yù)測前期糖尿病的早期標(biāo)志物,。前期糖尿病表現(xiàn)為血糖濃度開始上升，并保持在正常值以上,，這表明血糖無法被細(xì)胞正常吸收,。
大約5400萬美國人患有前期糖尿病，一旦得不到控制,，經(jīng)常會發(fā)展為嚴(yán)重的2型糖尿病,，并導(dǎo)致心臟疾病、中風(fēng),、腎病,、失明和神經(jīng)損傷。
在7月的Diabetes Care中,，UB的科學(xué)家報道了高濃度的cystatin C預(yù)示著患上前期糖尿病的幾率增加3倍。cystatin C的分析基于1996年到2001年之間Western New York健康研究項目獲得的數(shù)據(jù),，其中研究者隨機收集了伊利縣和尼亞加拉縣居民一系列指示物質(zhì)的信息,。
在2001年到2004年間，科學(xué)家對1455名參與者進(jìn)行了再次研究,。然后研究人員再次收集了指示物質(zhì)的數(shù)據(jù),。結(jié)果證實,，91位在1996年時血糖正常的參與者發(fā)展出了前期糖尿病?？茖W(xué)家隨即對這91位患者的血樣進(jìn)行了cystatin C濃度測試,，并和273位沒有患上前期糖尿病的最初參與者進(jìn)行了比較。
結(jié)果證明,，在高濃度的cystatin C和前期糖尿病之間存在直接的關(guān)系,。即使在考慮了和傳統(tǒng)的糖尿病相關(guān)的因素——例如體重、血糖濃度,、吸煙史,、高血壓或者酗酒——之后，這兩者之間的關(guān)系也沒有變化,。作者Donahue說：“腎臟早期損傷的臨床征兆或許同樣適于前期糖尿病,。因此前期糖尿病患者可能需要檢查他們的腎臟。” （引自教育部科技發(fā)展中心）
英文原文鏈接：http://www.physorg.com/news102610933.html
原始出處:
Diabetes Care Publish Ahead of Print published online ahead of print April 24, 2007
DOI: 10.2337/dc07-0040
Epidemiology/Health Services/Psychosocial Research
Original Article
Elevated Cystatin C Concentration and Progression to Pre-Diabetes
The Western New York Study
Richard P. Donahue, PHD1, Saverio Stranges, MD1,2, Karol Rejman, MS1, Lisa B. Rafalson, MS1, Jacek Dmochowski, PHD1,3 and Maurizio Trevisan, MD, MS1
1 Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, New York
2 Clinical Science Research Institute, Warwick Medical School, Coventry, U.K.
3 Department of Mathematics and Statistics, University of North Carolina Charlotte, Charlotte, North Carolina
Address correspondence and reprint requests to Richard P. Donahue, PhD, MPH, Department of Social and Preventive Medicine, School of Public Health and Health Professions, State University of New York at Buffalo, 3435 Main St., Farber Hall, Room 268 F, Buffalo, NY 14214. E-mail: [email protected]
OBJECTIVE— We conducted a nested case-control investigation to examine whether elevated baseline concentrations of cystatin C predicted progression from normoglycemia to pre-diabetes over 6 years of follow-up from the Western New York Health Study.
RESEARCH DESIGN AND METHODS— In 2002–2004, 1,455 participants from the Western New York Health Study, who were free of type 2 diabetes and known cardiovascular disease at baseline (1996–2001), were reexamined. An incident case of pre-diabetes was defined as an individual with fasting glucose <100 mg/dl at the baseline examination and 100 and 125 mg/dl at the follow-up examination, thereby eliminating individuals with prevalent pre-diabetics. All case patients (n = 91) were matched 1:3 to control participants based on sex, race/ethnicity, and year of study enrollment. All control subjects had fasting glucose levels <100 mg/dl at both baseline and follow-up examinations. Cystatin C concentrations and the urinary albumin-to-creatinine ratio were measured from frozen (–196°C) baseline blood and urine samples. Serum creatinine concentrations were available from the baseline examination only.
RESULTS— Multivariate conditional logistic regression analyses adjusted for age, baseline glucose level, homeostasis model assessment of insulin resistance, BMI, hypertension, estimated glomerular filtration rate, cigarette smoking, and alcohol use revealed a significantly increased risk of progression to pre-diabetes among those with elevated baseline concentrations of cystatin C (odds ratio 3.28 [95% CI 1.43–7.54]) (upper quintile versus the remainder). Results of secondary analyses that considered high-sensitivity C-reactive protein, interleukin-6, E-selectin, or soluble intercellular adhesion molecule-1 did not alter these results.
CONCLUSIONS— These results suggest that cystatin C was associated with a threefold excess risk of progression to pre-diabetes in this population.
Abbreviations: ACR, albumin-to-creatinine ratio • CVD, cardiovascular disease • DPP, Diabetes Prevention Program • eGFR, estimated glomerular filtration rate • GFR, glomerular filtration rate • hs-CRP, high-sensitivity C-reactive protein • IL-6, interleukin-6 • sE-selectin, soluble E-selectin • HOMA-IR, homeostasis model assessment of insulin resistance • IFG, impaired fasting glucose • IGT, impaired glucose tolerance • sICAM-1, soluble intercellular adhesion molecule-1
