生物谷综合： 一种称为血清半胱氨酸蛋白酶抑制物C（cystatin C）的血液组分常用来诊断早期肾脏损伤，但Buffalo大学进行的研究结果显示，cystatin C同样是预测前期糖尿病的早期标志物。前期糖尿病表现为血糖浓度开始上升，并保持在正常值以上，这表明血糖无法被细胞正常吸收。
大约5400万美国人患有前期糖尿病，一旦得不到控制，经常会发展为严重的2型糖尿病，并导致心脏疾病、中风、肾病、失明和神经损伤。
在7月的Diabetes Care中，UB的科学家报道了高浓度的cystatin C预示着患上前期糖尿病的几率增加3倍。cystatin C的分析基于1996年到2001年之间Western New York健康研究项目获得的数据，其中研究者随机收集了伊利县和尼亚加拉县居民一系列指示物质的信息。
在2001年到2004年间，科学家对1455名参与者进行了再次研究。然后研究人员再次收集了指示物质的数据。结果证实，91位在1996年时血糖正常的参与者发展出了前期糖尿病。科学家随即对这91位患者的血样进行了cystatin C浓度测试，并和273位没有患上前期糖尿病的最初参与者进行了比较。
结果证明，在高浓度的cystatin C和前期糖尿病之间存在直接的关系。即使在考虑了和传统的糖尿病相关的因素——例如体重、血糖浓度、吸烟史、高血压或者酗酒——之后，这两者之间的关系也没有变化。作者Donahue说：“肾脏早期损伤的临床征兆或许同样适于前期糖尿病。因此前期糖尿病患者可能需要检查他们的肾脏。” （引自教育部科技发展中心）
英文原文链接：http://www.physorg.com/news102610933.html
原始出处:
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: rpd1@buffalo.edu
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
