Diagnostic value of combined measurement of serum Hcy,serum Cys C,urinary microalbumin and urinary creatinine ratio levels in type 2 diabetes mellitus with early kidney injury

Objective To explore the diagnostic value of combined measurement of serum homocysteine(Hcy),serum cystatin C(Cys C),urinary microalbumin(UmAlb) and urinary creatinine(UCr) ratio levels in type 2 diabetes mellitus with early kidney injury.Methods 182 cases of type 2 diabetes mellitus(T2DM)patients were enrolled and divided into three groups according to the excretion rate 24 hour urinary microalbumin.A group without diabetic nephropathy(UmAlb30 mg/24 h)(NDN,60cases),B group with early diabetes nephropathy(30 mg/24 h≤UmAlb≤300 mg/24 h(EDN,62 cases),C group with apparent diabetic nephropathy(UmAlb300 mg/24 h(ADN,60 cases),and 50 healthy people served as normal control group(D group).Serum Cys C,Serum homocysteine,urinary microalbumin,urinary creatinine,serum creatinine and blood urea nitrogen of these four groups were detected simultaneously.Results Levels of serum Hcy,serum Cys C,UmAlb/UCr ratio in these two groups(B,C group)were higher than D group,Serum Hcy,serum Cys C,UmAlb/UCr ratio were significantly different between group B,C and group D(P0.05).Levels of serum Hcy,serum Cys C,UmAlb/UCr ratio in these two groups(B,C) were higher than A group.Serum Hcy,serum Cys C,UmAlb/UCr ratio were significantly different between group B,C and group A(P0.05).Levels of serum Hcy,serum Cys C,UmAlb/UCr ratio in the group C were higher than group B.Serum Hcy,serum Cys C,UmAlb/UCr ratio were significantly different between group C and group B(P0.05).As a single positive marker for diagnosis,the sensitivity for serum CysC,serum Hcy,and UmAlb/UCr were 85.2%,80.3% and 86.9%respectively,the positive rate of combined detection was 96.7%,which was significantly higher than that of the individual testing(P0.05).Conclusion Combined measurement of serum Hcy,serum Cys C,and UmAlb/UCr ratio levels has important clinical value for diagnosis and condition monitoring in type 2 diabetes mellitus with early kidney injury.