Diagnostic Value of CysC,Hcy,Scr,FIB and D-D Detected in Combina-tion in Diabetic Nephropathy and Their Relationship with Renal Injury Grade

ZHAI Jianjin; HUANG He; ZHANG Rui; GUAN Jie; LI Li

doi:10.3969/j.issn.1002-3429.2025.05.014

Abstract：Objective To investigate the value of cystatin C(CysC),homocysteine(Hcy),serum creatinine(Scr),fibrinogen(FIB),D-dimer(D-D)detected in combination in the diagnosis of diabetic kidney disease(DKD)and its relationship with the renal injury grade of DKD.Methods The clinical data of 163 patients with type 2 diabetes mellitus(T2DM)treated from August 2023 to July 2024 were retrospectively analyzed.They were divided into DKD group(n=83)and non-DKD group(n=80)according to the occurrence of DKD,and another 80 healthy physical examinees were selected as control group.The levels of CysC,Hcy,Scr,FIB and D-D in the three groups were compared,the influencing factors of DKD in T2DM patients were analyzed by multivariate logistic regression analysis,and the correlation among CysC,Hcy,Scr,FIB and D-D was analyzed by Spearman correlation.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of CysC,Hcy,Scr,FIB and D-D detection in DKD patients with different renal injury grades,and the serum levels of CysC,Hcy,Scr,FIB and D-D were analyzed to explore the relationship between each index and the renal injury grades of DKD.Results The levels of CysC,Hcy,Scr,FIB and D-D in DKD group were significantly higher than those in non-DKD group and control group(P＜0.05).The levels of CysC and Hcy in non-DKD group were significantly higher than those in control group(P＜0.05).CysC and FIB were independent risk factors for DKD in T2DM patients(P＜0.05).Spearman correlation analysis showed that Hcy,Scr and D-D were all positively correlated with CysC and FIB,and CysC was also positively correlated with FIB(P＜0.01).The area under the curve(AUC)of the combined detection of CysC,Hcy,Scr,FIB,and D-D in the diagnosis of DKD was significantly higher than that of each index detected alone(P＜0.01).The levels of CysC,Hcy and Scr in DKD patients with different renal injury grades were compared and found to be the highest in patients with stage V,followed by stage Ⅳ,stage Ⅲ and stage Ⅱ and Ⅰ(P＜0.05).Conclusion CysC,Hcy,Scr,FIB and D-D all have certain diagnostic value for DKD,and the diagnostic accuracy of combined detection is higher than that of each index alone,which can improve the diagnostic accuracy of DKD.Meanwhile,these indexes are also closely related to re-nal injury grades,and are expected to become an index to evaluate the renal injury grades of DKD.