Clinical value of homocysteine and ultrasensitive C-reactive protein in diabetic nephropathy.

Objective To evaluate the changes of serum homocysteine(HCY),high sensitive C-reactive protein(hsCRP) and Cystatin C(Cys C) level in different levels of urinary albumin excretion rate(UAER) and to investigate its relativity in diabetes nephropathy(DN).Methods 136 patients with type 2 diabetic(T2DM) were divided into simple diabetic mellitus(SDM group),early diabetic nephropathy(EDN group) and clinical diabetic nephropathy(CDN group) according to 24 h UAER.30 normal persons were chosen in normal control group.Plasma HCY,hsCRP and CysC were determined and analyzed.Results Cys C in SDM,EDN and CDN group was(0.65±0.16) mg/L,(0.89±0.45) mg/L and(1.69±0.82) mg/L all significantly higher than that of control group(0.62±0.18) mg/L.HCY in the former three groups was(8.38±2.76) μmol/L,(9.46±2.11) μmol/L and(13.34±4.86) μmol/L also significantly higher than that of control group (6.89±0.29) μmol/L.hsCRP in the three groups was(2.68±1.67) mg/L,(4.98±3.48) mg/L and(11.72±4.86) mg/L higher than that of control group(0.76±0.47) mg/L(all P0.01).Significant difference existed in SDM,EDN and CDN group(P0.05 or 0.01).With the increase of UAER level,CCr reduced gradually,CCr in CDM group was significantly lower than that in control,SDM and END group,CCr(69.13±1.25) ml/min vs(89.25±13.8) ml/min,(91.50±12.6) ml/min,(87.12±24.6) ml/min(all P0.01).HCY and hsCPR were correlated positively with UAER and Cys C respectively in all diabetic patients(r=0.482,0.416,P0.05;r=0.642,0.757,P0.01).Conclusion Increment of HCY and hsCPR may be related to the progression of DN.With their levels increased,nephropathy in type 2 diabetic patients would be severe.They could be used as the pathogenetic condition monitoring indexes for diabetic nephropathy.