당뇨병환자의 신기능 평가지표로서 혈청 cystatin C 측정의 유용성

Abstract

Backgroud : Diabetic nephropathy is most common complication in the DM patients. In clinical practices, the glomerular filtration rate (GFR) is often estimated from serum creatinine. Serum cystatin C have shown to be a better parameter for diagnosis impaired of renal function as a potential new marker of GFR in diabetes patients. Method : Serum cystatin C and serum creatinine (sCr) were measured in 73 (34 males, 39 females) DM patients to evaluate their usefulness in diabetic patients. The results were compared with creatinine clearance, which was measured (mCcr) and estimated with Cockroft-Gault formular (eCcr). Results : The overall correlation coefficient for the reciprocal of serum cystatin C (r=0.637) was superior to that of the reciprocal of a serum creatinine (r=0.516). With a cutoff value of 60mL/min, receiver operating characteristic (ROC) plot demonstrated that the area under the curve (AUC) of serum cystatin C (0.79) was greater than that of serum creatinine (0.67). and so, serum cystatin C showed higher sensitivity for detecting decreased glomerular filtration rate than did serum creatine (86%, 77% respectively) Conclusion : These finding suggest that serum cystatin C is superior to serum creatinine as a marker of GFR measured by correlation or mean ROC-plot AUC in diabetic patients.