The value of uMCP 1, uKIM-1 and serum CysC levels in clinical diagnosis of type 2 diabetes mellitus related nephropathy

Abstract：Objective To investigate the diagnostic value of urine monocyte chemoattractant protein l (uMCP 1) , urine kidney injury molecule l ( uKIM-1 ) and serum cystatin C( CysC) in patients with type 2 diabetes mellitus (T2DM) complicated by diabetic nephropathy (DN). Methods A total of 112 patients with T2DM who were admitted and treated in our hospital from May 2013 to May 2016 were enrolled in the study. According to the degrees of albuminuria, these patients were divided into stage A1 group ( n=41) , microalbuminuria group ( stage A2 group, n = 39) , and severe albuminuria group ( stage A3 group, n= 32) ,at the same time, the other 31 healthy subjects were enrolled as control group. The peripheral blood were collected, and the serum CysC levels were detected, moreover the urine specimens were collected, and the levels of uMCP-1, uKIM-1 were detected. The clinical value of these indexes in diagnosis of DN was analyzed by means of ROC curve. Results The levels of uMCP-l/uCr, uKIM-l/uCr and serum CysC levels in different groups from high to low were ( 146.47 ±51. 60) pg/mg , ( 424. 03±195. 26) pg/mg, (4. 44±1. 90) mg/ml in stage A3 group ,and ( 114. 34±38. 76) pg/mg, ( 255. 58 ±94. 64 ) pg/mg, (2. 45±0. 91 ) mg/ml in stage A2 group , and ( 79. 06±28. 02 ) pg/mg, ( 187. 32 ±80. 06 ) pg/mg, ( 1. 94±1. 22) mg/ml in stage A1 group , and ( 48. 26±18. 98 ) pg/mg, ( 69. 94±39. 46 ) pg/mg, ( 0. 43±0. 09 ) mg/ml in control group. The AUC of uMCP-1/uCr in diagnosis of renal function damage was 0.790, the AUC of uKIM-1/uCr was 0.786,and the AUC of CysC was 0.789. The AUC of uMCP-1/uCr combined with CysC was 0. 802, the AUC of uKIM-1/uCr combined with CysC was 0.786, the AUC of uMCP-1/uCr and uKIM-1/uCr combined with CysC was 0. 862. Conclusion The uMCP-1 , uKIM-1 and CysC can be used for diagnosis of DN in patients with T2DM, and the combination detection of three indexes has higher diagnositic value.