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糖尿病肾病(diabetic nephropathy)是糖尿病的主要慢性并发症之一,已成为终末期肾功能衰竭的首位原因。肾功能主要由肾小球滤过率(renal glomerular filtration rate,GFR)反映。近年来相关临床试验已证明,血清胱抑素C(cystatin C,Cys C)与GFR有良好相关性,可以将其作为GFR的替代指标用于糖尿病肾病的诊断。Cys C是一种低分子量蛋白质,相对分子量小,是半胱氨酸蛋白酶抑制物超家族的成员之一,可由机体所有有核细胞产生,产生率恒定。循环中的Cys C能够自由通过肾小球滤过膜,并在近曲小管几乎完全被重吸收,不再重新回到血液循环中,同时,肾小管也不分泌Cys C,因此它是一种反映肾小球滤过率变化的理想的内源性标志物。Cys C测定的方法学也在不断发展,使血清Cys C测定在糖尿病肾病早期诊断的临床应用和推广成为可能。
Diabetic nephropathy, one of the major chronic complications of diabetes, has become the leading cause of end-stage renal failure. Renal function is mainly reflected by renal glomerular filtration rate (GFR). In recent years, relevant clinical trials have shown that serum cystatin C (Cys C) has a good correlation with GFR and can be used as a surrogate marker of GFR for the diagnosis of diabetic nephropathy. Cys C is a low molecular weight protein with relatively low molecular weight and is a member of the superfamily of cysteine protease inhibitors. It can be produced by all the nucleated cells in the body with a constant rate of production. Cys C in the circulation is free to pass through the glomerular filtration membrane and is almost completely reabsorbed in the proximal convoluted tubule and no longer returns to the blood circulation, nor does the tubule secrete Cys C, so it is a Reflect the change of glomerular filtration rate of the ideal endogenous markers. Cys C determination of the methodology is also evolving, so that the serum Cys C determination in the early diagnosis of diabetic nephropathy clinical application and promotion as possible.