당뇨병성 신증의 조기 예측 인자로서의 혈중 cystatin C 및 β2-microglobulin의 유용성

Abstract

Purpose : Early detection of diabetic nephropathy is very important for prevention of renal failure. Determination of microalbuminuria has been suggested as an early predictor of diabetic nephropathy, but it is tend to be erroneous and inaccurate, especially in childhood. The aim of this study is to show clinical values of serum cystatin C and β2-microglobulin in the assessment of renal function in diabetic children and adolescents. Methods : Ninety four type 1 and 2 diabetic patients with normoalbuminuria (n=78), microalbuminuria (n= 15) and macroalbuminuria (n=1) were enrolled. Serum concentration of cystatin C, β2-microglobulin, creatinine, urinary microalbumin levels and creatinine clearances were determined. Results : In patients with microalbuminuria, serum concentration of cystatin C was increased significantly in comparison to patients with normoalbuminuria (P<0.05), while no differences were observed for β2- microglobulin levels. Serum creatinine concentrations were not different between both groups. Serum concentration of cystatin C was positively correlated with serum β2-microglobulin and serum creatinine. The serum concentration of β2 -microglobulin was not correlated with the decrease of renal function significantly. Conclusion : Serum cystatin C is a useful endogenous marker in assessment of renal function in pediatric diabetic patients.