Abstract: Keeb kwm thiab lub hom phiaj: Txoj kev tshawb no yog tsom rau kev soj ntsuam qhov tseem ceeb ntawm cov ntshav cystatin C hauv kev kuaj mob ntxov ntawm lub raum raug mob thiab nws cov koom haum nrog dyslipidemia hauv cov tub ntxhais hluas T1D cov neeg mob. Cov ntaub ntawv thiab cov txheej txheem: Tag nrho ntawm 779 cov kev kawm tau raug soj ntsuam rau lub raum ua haujlwm los ntawm kev kwv yees glomerular filtration rate (eGFR) raws li cov ntshav creatinine (eGFRcreat) thiab cystatin C (eGFRcys). Cov txiaj ntsig: Lub hnub nyoog nruab nrab ntawm cov kev kawm yog 16.2 xyoo (2.1; 26.4), thiab mob ntshav qab zib ntev - yog 5.3 xyoo ({{10}}.51; 24.0). Qhov nruab nrab ntawm HbA1c yog 8 feem pua ​​(5.2; 19.9) (64 mmol / mol (33.3; 194)); 24.2 feem pua ​​​​ntawm cov neeg koom nrog HbA1c <7 feem pua ​​(53 mmol/mol). Qhov siab ntawm albumin excretion tus nqi tau pom hauv 13.5 feem pua ​​​​ntawm cov neeg mob. Qhov nruab nrab ntawm cystatin C yog 0.8 mg / L (0.33; 1.71), thiab qhov nruab nrab ntawm creatinine - yog 63 μmol / L (6; 126). Qhov nruab nrab ntawm eGFRcys qis dua eGFRcreat (92 mL/min/1.73 m2 vs. 101 mL/min/1.73 m2, p < 0.00 1). Tag nrho ntawm 30.2 feem pua ​​​​ntawm tag nrho cov neeg mob tau muab cais ua lub raum ua haujlwm tsis zoo thaum siv cystatin C vs. creatinine rau eGFR xam. Cov kab sib txuas tau pom ntawm cystatin C thiab HbA1c, r=−0.088, p <0.05, as well as cystatin C thiab HDL, r=−0.097, p <0.01. Cov ntsiab lus: Txoj kev tshawb no tau pom tias cystatin C tuaj yeem siv los ua ib qho biomarker ntxiv ntawm kev raug mob raum thaum ntxov hauv cov neeg mob hluas nrog T1D.

Raws li cov kev tshawb fawb muaj feem xyuam, cistanche yog ib txwm suav tshuaj ntsuab uas tau siv rau ntau pua xyoo los kho ntau yam kab mob. Nws tau raug pov thawj scientific kom muaj cov tshuaj tiv thaiv kab mob, tiv thaiv kev laus, thiab antioxidant zog. Cov kev tshawb fawb tau pom tias cistanche muaj txiaj ntsig zoo rau cov neeg mob uas muaj kab mob raum. Cov khoom xyaw nquag ntawm cistanche paub tias txo qhov mob, txhim kho lub raum ua haujlwm thiab rov ua kom lub raum tsis zoo. Yog li, kev sib koom ua ke cistanche hauv txoj kev npaj kho mob raum tuaj yeem muab txiaj ntsig zoo rau cov neeg mob hauv kev tswj hwm lawv tus mob. Cistanche pab txo qis proteinuria, txo qis BUN thiab creatinine qib, thiab txo qhov kev pheej hmoo ntawm lub raum puas. Tsis tas li ntawd, cistanche kuj pab txo cov roj cholesterol thiab triglyceride uas tuaj yeem ua rau muaj kev phom sij rau cov neeg mob uas muaj kab mob raum.

Nyem qhov no mus saib Cistanche khoom

【Yog xav paub ntxiv: david.deng@wecistanche.com / WhatApp:86 13632399501 】

1. Taw qhia

Mob raum mob ntshav qab zib yog txhais tau tias yog lub raum tsis ua haujlwm lossis kev ua haujlwm tsis zoo uas kav ntev li 3 lossis ntau lub hlis thiab cuam tshuam rau tus neeg mob lub neej zoo [1]. Pib nrog glomerular hypertrophy, hyperfiltration, thiab hyperperfusion, ntshav qab zib lub raum kev puas tsuaj nce mus rau theem kawg ntawm lub raum kab mob, uas yog ib qho ntawm cov ua rau mob thiab tuag rau cov hluas hom 1 mob ntshav qab zib [2]. Qhov kwv yees glomerular filtration rate (eGFR) qis dua 60 mL / min / 1.73 m2 txiav txim siab txog kab mob raum. Cov ntaub ntawv tsis ntev los no qhia txog cov txiaj ntsig ntawm GFR suav nrog cov ntshav cystatin C rau kev soj ntsuam ntawm kev pheej hmoo ntxov rau theem kawg ntawm lub raum [3].

Cystatin C yog cov protein uas tsis muaj molecular-yuag (Mw 13,343 Da), ib qho inhibitor ntawm endogenous cysteine ​​protease [4]. Nws yog tsim nyob rau hauv tag nrho cov ntaub so ntswg thiab pom nyob rau hauv tag nrho cov biological kua. Los ntawm kev tswj hwm cysteine ​​protease kev ua ub no, cystatin C tau tshaj tawm tias koom nrog ntau yam kab mob, xws li o thiab qog nqaij hlav metastasis [5]. Cov kev tshawb fawb tsis ntev los no tau pom tias cystatin C yog qhov zoo tshaj plaws endogenous glomerular filtration rate marker [6,7] thiab yog ib qho rhiab heev rau kev ntsuas lub raum ua haujlwm piv rau cov ntshav creatinine [4].

Kev nce cystatin C thiab teeb meem ntawm lipid metabolism yog txuam nrog kev pheej hmoo siab ntawm cov kab mob plawv (CVD), uas yog qhov ua rau tuag rau cov neeg mob ntshav qab zib hom 1 (T1D) [7-9]. Kev soj ntsuam ntxov ntawm lipid profile hauv cov neeg mob T1D, qhia txog cov yam ntxwv ntawm atherogenic, xws li hypercholesterolemia thiab hypertriglyceridemia, cuam tshuam nrog glycemic tswj tsis zoo thiab lub raum puas [8-10].

Cov kev tshawb fawb tsis ntev los no tau pom tias cystatin C yog qhov cim tseem ceeb rau mob raum raug mob hauv cov menyuam yaus thiab txawm tias yuav pab kho CVD kev pheej hmoo rau cov menyuam yaus uas muaj mob raum [11,12]. Txawm li cas los xij, hauv Kev Tshawb Fawb Txog Kev Mob Ntshav Qab Zib hauv Cov Tub Ntxhais Hluas, qib siab dua ntawm cystatin C tau pom hauv cov neeg noj qab haus huv piv rau cov neeg mob ntshav qab zib hom 1 thiab hom 2 [13].

Txij li thaum muaj kev tsis sib haum xeeb txog lub luag haujlwm ntawm cystatin C hauv kev ntsuam xyuas ntawm lub raum kev ua haujlwm, peb tsom mus soj ntsuam qhov tseem ceeb ntawm cov tshuaj cystatin C hauv kev kuaj mob ntxov ntawm lub raum raug mob thiab nws cov koom haum nrog dyslipidemia hauv cov tub ntxhais hluas T1D cov neeg mob.

2. Cov ntaub ntawv thiab cov txheej txheem

2.1. Kawm Tsim thiab Kawm

Ib txoj kev tshawb nrhiav cov pej xeem-raws li tau ua nyob rau hauv Lithuanian University of Health Sciences, Department of Endocrinology, tag nrho cov haujlwm tau piav qhia yav dhau los [14]. Txoj kev tshawb no tshwj xeeb yog ib feem ntawm tag nrho cov haujlwm, ntawm no, peb suav nrog 531 cov menyuam yaus thiab 248 tus neeg laus hnub nyoog qis dua 26 xyoo nrog kev kuaj mob T1D hauv Lithuania. Txhua tus neeg mob tau raug lees paub tias muaj kev kuaj mob T1D nrog tsawg kawg ib qho zoo islet autoimmune marker: glutamic acid decarboxylase 65-kilodalton isoform, tyrosine phosphatase-related islet antigen 2 thiab/los yog insulin autoantibodies; thiab tau kho nrog insulin. Peb suav nrog cov neeg mob uas muaj tus kab mob ntev tshaj li 6 lub hlis vim paub tias metabolic tsis ruaj khov thaum pib mob ntshav qab zib [15].

Cov ncauj lus kom ntxaws txog kev soj ntsuam thiab kev soj ntsuam ntawm pawg neeg no tau piav qhia yav dhau los [16], luv luv ntawm kev tshawb fawb nkag, thiab cov ntaub ntawv ntawm qhov pib, lub sijhawm, thiab kev kho mob ntshav qab zib tau sau tseg, kev tshuaj ntsuam xyuas suav nrog qhov siab (cm), qhov hnyav (kg), lub duav. Kev ntsuas qhov ntev (cm) thiab lub cev qhov hnyav (BMI) (kg / m2). BMI qhov tseem ceeb tau hloov mus rau Z-cov qhab nia thiab stratified rau hauv 4 pawg xwm txheej hnyav: qis dua, qhov hnyav li qub, rog dhau, thiab rog, siv World Health Organization mus kom ze [17]. Lub duav ncig (cm) muab faib los ntawm qhov siab (cm) qhov tseem ceeb tau siv los ntsuas qhov Waist-to-Height ratio (WtHR): zoo WtHR tau txiav txim siab<0.5 [18]. 

Kev tswj ntshav qab zib tau raug ntsuas los ntawm glycated hemoglobin (HbA1c). Kev kuaj ntshav yoo mov tau raug coj mus rau kev soj ntsuam ntawm lipid profile, creatinine, thiab cystatin C. Txhua tus neeg mob tau kuaj mob ntshav qab zib retinopathy thiab neuropathy, thiab qib albuminuria hauv 24-h tso zis tau soj ntsuam.

2.2. Laboratory Analyzes

HbA1c, lipids, thiab serum creatinine tau ntsuas siv UniCel DxC 800 Synchron system (Beckman Coulter, Brea, CA, USA). Kev txiav tawm ib txwm muaj rau HbA1c yog 4-6 feem pua ​​(20 mmol/mol–42 mmol/mol). Kev tswj hwm cov metabolism zoo tshaj plaws tau txhais tias yog HbA1c qis dua 7 feem pua ​​(53 mmol / mol) yam tsis muaj mob hnyav hypoglycemias raws li kev pom zoo los ntawm International Society for Pediatric and Adolescent Diabetes (ISPAD) [19]. Cov txiaj ntsig zoo li qub rau cov roj lipoproteins tsawg ntom ntom (LDL), cov roj lipoprotein ntau ntom ntom (HDL), thiab triglycerides (Tg) tau txhais tias yog<2.6 mmol/L, >1.1 mmol / L, thiab<1.7 mmol/L, respectively. Normal values for total cholesterol (TCh) were <5.2 mmol/L for patients ≥16 years and <5.5 mmol/L  for children under 16 years. At least one abnormal lipid level indicated dyslipidemia. Normal cut-off values for creatinine were 39–91 µmol/L. Cystatin C was measured by an automated enzyme immunoassay system AIA 2000 (TOSOH Corporation, Tokyo, Japan)  with a normal range of 0.52–0.97 mg/L.

2.3. Kev ntsuas lub raum ua haujlwm

Qhov kwv yees glomerular filtration rate (eGFR) qhov tseem ceeb tau suav nrog cov ntshav creatinine (eGFRcreat) thiab ntshav cystatin C (eGFRcys) rau txhua tus neeg koom. Creatinine-based Schwartz formula [20] rau eGFRcreat yog siv los xam eGFRcreat hauv cov menyuam yaus. Rau eGFRcreat thiab eGFRcys hauv cov neeg laus thiab eGFRcys hauv cov menyuam yaus, kev sib npaug los ntawm Kev Sib Raug Zoo ntawm Cov Kab Mob Raum Kab Mob Sib Kis tau siv [21,22].

Lub raum ua haujlwm tau ua tiav raws li American Diabetes Association (ADA) cov lus qhia [23]: Qib 1 yog GFR Ntau dua lossis sib npaug li 90 mL / min./1.73 m2 ; Qib 2-GFR 60–89 mL/min/1.73 m2; Qib 3-GFR 30–59 mL/min/1.73 m2; Qib 4—GFR 15–29 mL/min/1.73 m2 thiab Theem 5—GFR <15 mL/min/1.73 m2 .

Tsis tas li ntawd, peb tau faib cov neeg mob raws li eGFRcreat thiab eGFRcys qib: Pawg 1-yog tias qib eGFRcreat sib npaug rau qib eGFRcys; Pawg 2—yog eGFRcreat qib < eGFRcys qib; Pawg 3—yog eGFRcreat qib> eGFRcys qib.

2.4. Kev ntsuam xyuas ntawm Microvascular Complications

Cov duab digital fundus tau coj thiab tshuaj xyuas los ntawm ib tus kws kho mob tshwj xeeb hauv ntshav qab zib retinopathy.

Txhua tus neeg mob tau kuaj xyuas qib albuminuria hauv 24-h tso zis raws li qhia ua ntej [24]. Cov txiaj ntsig ib txwm raug txiav txim siab yog tias qhov albumin excretion rate (AER) qis dua 30 mg / 24 h; nce qib albuminuria - nruab nrab ntawm 30 thiab 300 mg / 24 h; nce albuminuria ntau dua - ntau dua 300 mg / 24 teev.

Txhua tus neeg mob tau kuaj pom muaj cov tsos mob lossis cov tsos mob ntawm symmetrical peripheral neuropathy. Peb tau thov Michigan Neuropathy Kev Tshawb Fawb Cov Lus Nug thiab ntsuas qhov kev xav ntawm kev vibration, siab, thiab kub. Kev kuaj mob ntawm peripheral neuropathy tau lees paub yog tias ob lossis ntau qhov kev ntsuas no txawv txav [25,26].

2.5. Kev Tshawb Fawb Txog Kev Tshawb Fawb

IBM SPSS Statistics software tau siv rau kev txheeb xyuas kev txheeb xyuas. Cov tub ntxhais kawm ntawv {{0}} tailed t-test, χ 2 statistics, parametric one-way ANOVA (rau ib txwm faib cov ntaub ntawv), thiab Mann– Whitney U-test (rau cov ntaub ntawv tsis zoo sib xws) lossis Kruskal–Wallis ib- txoj kev ANOVA (nyob rau hauv cov ntaub ntawv ntawm ordinal data) tau siv. Pearson correlation coefficient (rau ib txwm faib cov ntaub ntawv), thiab Spearman's coefficient (rau cov ntaub ntawv tsis zoo) tau siv thaum kuaj kev sib koom ua ke ntawm qhov sib txawv tsis tu ncua. p-tus nqi <0.05 tau suav tias yog qhov tseem ceeb. Tag nrho p-tus nqi tau 2-tailed.

3. Cov txiaj ntsig

3.1. Cov yam ntxwv dav dav ntawm Pawg

Zuag qhia tag nrho, 779 cov neeg mob nrog T1D tau suav nrog hauv txoj kev tshawb no, 51.2 feem pua ​​(n=399) yog poj niam. Lub hnub nyoog nruab nrab ntawm kev suav nrog yog 16.2 xyoo (2.1; 26.4), hnub nyoog thaum pib ntawm T1D - yog 9.4 xyoo (0.8; 24.9), thiab lub sijhawm nruab nrab ntawm ntshav qab zib yog 5.3 xyoo ({{2 0}}.51; 24.0). Muaj 51.9 feem pua ​​(n=404) ntawm cov neeg mob ntshav qab zib ntev ntev dua lossis sib npaug li 5 xyoos.

Ib txwm BMI tau pom nyob rau hauv 75.3 feem pua ​​(n=581) ntawm cov neeg koom, 20.1 feem pua ​​(n=155) rog, 3.6 feem pua ​​(n=28) ​​- rog, thiab 1 feem pua ​​(n=8)—tsis hnyav. Optimal WtHR tau pom nyob rau hauv 85.3 feem pua ​​(n=622) ntawm cov neeg koom.

Kev tswj glycemic zoo tau pom hauv 24.2 feem pua ​​(n=188) ntawm txhua tus neeg mob. Siab dua li cov ntshav cystatin C concentration nyob rau hauv 10.8 feem pua ​​(n=84) ntawm txhua tus neeg mob.

Cov yam ntxwv dav dav thiab kev sib piv ntawm cov menyuam yaus thiab cov neeg laus thiab cov txiv neej thiab poj niam muaj nyob rau hauv Table 1.

3.2. Dyslipidemia thiab Microvascular Complications

Muaj 26.1 feem pua ​​​​ntawm cov neeg mob uas muaj tsawg kawg yog ib qho teeb meem microvascular. Retinopathy tau kuaj pom hauv 9 feem pua ​​​​ntawm cov neeg mob nyob rau hauv tag nrho pawg, thiab neuropathy hauv 10.8 feem pua. Tag nrho ntawm 13.5 feem pua ​​​​tau pom tias tau nce AER, thiab 49.5 feem pua ​​​​ntawm lawv tau nce qib albuminuria. Qhov zaus ntawm cov teeb meem microvascular, dyslipidemia, thiab rog rog tau nthuav tawm hauv Table 2.

Cov neeg mob uas kuaj pom retinopathy, neuropathy, thiab nce qib albuminuria tau tswj glycemic phem dua li cov uas tsis muaj cov teeb meem no, HbA1c 9.6 feem pua ​​​​vs. 7.9 feem pua, 8.8 feem pua ​​vs. 7.9 feem pua, thiab 8.6 feem pua ​​vs. < 0 05. Cov neeg mob dyslipidemia muaj HbA1c siab dua li cov neeg mob uas muaj lipids ib txwm muaj, 8.3 feem pua ​​​​vs. 7.6 feem pua, raws li, p <0.001.

Lub sijhawm mob ntshav qab zib tau cuam tshuam ncaj qha rau HbA1c, creatinine, AER, TCh, LDL, thiab Tg concentrations. Cov kev sib raug zoo tsis zoo tau pom ntawm cystatin C thiab HbA1c, r=−0.088, p < 0.{{10}}5 , as well as cystatin C thiab HDL, r=−{15}}.097, p < 0.01. HbA1c cuam tshuam ncaj qha nrog TCh, LDL, Tg, eGFRcreat, thiab eGFRcys, p <0.001, thiab tsis zoo nrog HDL, p <0.05. Txhua qhov kev sib raug zoo tau nthuav tawm hauv Table 3; Kev sib raug zoo ntawm Cystatine thiab eGFRcys nrog rau Creatinine thiab eGFRcreat tau nthuav tawm hauv daim duab 1.

3.3. GFR thiab raum ua haujlwm

Qhov nruab nrab ntawm eGFRcys qis dua hauv tag nrho pawg piv rau eGFRcreat, 92 (57; 201) vs. 101 (51; 194) mL/min/1.73 m2, ntsig txog, p <0.001. Ib qho kev sib txawv tseem ceeb tau pom nyob hauv pawg menyuam yaus piv rau eGFRcreat vs. eGFRcys, 97 (51; 169) vs. 87 (57; 201) mL/min/1.73 m2, p < 0.001.

Kev faib ua pawg ntawm txhua tus neeg mob los ntawm theem kev ua haujlwm hauv lub raum siv eGFRcreat lossis eGFRcys tau nthuav tawm hauv daim duab 2. Muaj ntau tus neeg mob cais nrog qib 2 lub raum ua haujlwm thaum siv cystatin C vs. creatinine rau kev suav eGFR, 44.7 feem pua ​​​​vs. 23.8 feem pua, raws li, p < 0.001.

Tom qab pab pawg neeg mob raws li qhov sib npaug ntawm eGFR qib xam los ntawm creatinine thiab cystatin C, peb pom tias 30.2 feem pua ​​​​ntawm cov neeg mob muaj cov qib eGFR zuj zus suav nrog cystatin C (Pawg 2, thaum eGFRcreat qib < theem teebmeem), 61.1 feem pua ​​​​tau tib eGFR. qib siv ob qho tib si biomarkers (Pawg 1) thiab 8.7 feem pua, tau muab cais ua Pawg 3 (thaum eGFRcreat qib > theem teebmeem).

4. Kev sib tham

Cov kab mob hauv lub raum kawg hauv cov neeg mob ntshav qab zib tau paub tias yog qhov ua rau muaj kev pheej hmoo rau kev tuag ntxov ntxov [27]. Tsuas yog muaj cov cim qhia tseeb thiab txhim khu kev qha rau kev kuaj mob ntshav qab zib hauv lub raum thaum ntxov yuav ua rau muaj kev cuam tshuam ntxov [28]. Hauv txoj kev tshawb fawb tam sim no, peb tau soj ntsuam tus nqi ntawm serum cystatin C raws li biomarker rau mob ntshav qab zib raum raug mob hauv cov menyuam yaus thiab cov neeg laus nrog kev kuaj mob T1D.

Qhov kev tshawb pom tseem ceeb ntawm peb txoj kev tshawb fawb yog tias kev siv cystatin C pab nrhiav cov tub ntxhais hluas T1D cov neeg mob uas tej zaum yuav raug kev puas tsuaj rau lub raum thaum ntxov, raws li ib feem peb ntawm tag nrho pawg neeg raug cais nrog cov qib eGFR phem dua thaum siv cystatin C vs creatinine. Raws li pom nyob rau hauv Tsai et al. kawm qhov twg cov neeg laus siv eGFR raws li cystatin C tau pab txhawm rau txheeb xyuas lub raum kev ua haujlwm los ntawm kev khaws cia kom txo qis, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob ntshav qab zib [29], qhov no txhais tau tias cystatin C tuaj yeem siv los ua qhov kev kwv yees ua ntej ntawm lub raum kev puas tsuaj piv rau creatinine. Muaj ob peb txoj kev tshawb fawb txog tus nqi ntawm cov ntshav cystatin C hauv cov menyuam yaus uas muaj ntshav qab zib, tab sis feem ntau cov kev tshawb fawb soj ntsuam cystatin C hauv cov menyuam yaus uas raug mob raum. 2017 meta-analysis ntawm Nakhjavan-Shahraki et al. qhia tau hais tias cov ntshav cystatin C yog qhov muaj peev xwm ua rau lub raum puas tsuaj rau cov menyuam yaus piv rau cov ntshav creatinine [11].

Nws paub tias pathogenesis ntawm ntshav qab zib raum puas pib nrog glomerular hypertrophy, hyperfiltration, thiab hyperperfusion xeev [2], yog li nws yog ib qho tseem ceeb kom nrhiav tau ib tug txhim khu kev qha thiab resistant biomarker ntawm lub raum thaum ntxov raug mob nyob rau theem no. Huang et al. txoj kev tshawb fawb tau pom tias eGFR yog raws li cov proteins uas tsis muaj molecular-yuag, vim tias cystatin C tsis hloov pauv los ntawm hyperfiltration hauv cov menyuam yaus pawg [30]. Kev sib xyaw cov txiaj ntsig no nrog peb qhov kev tshawb pom nce qhov tseem ceeb ntawm kev siv cystatin C hauv kev kho mob.

Lim et al. pom tau hais tias cystatin C tsis yog tsuas yog ib qho biomarker txhim khu kev qha, tab sis kuj tseem cuam tshuam nrog kev rov qab los ntawm kev raug mob raum rau cov neeg laus mob hnyav [31]. Tsis tas li ntawd, Murty et al. pom tias cystatin C zoo tshaj creatinine rau GFR kwv yees nyob rau hauv lub raum raug mob thaum ntxov, tshwj xeeb tshaj yog nyob rau hauv lub thiaj li hu ua creatinine dig muag GFR cheeb tsam (40–70 mL / min / 1.73 m2) [32], tab sis txoj kev tshawb no tau ua rau ib tug neeg laus. cohort, qhov kev tshawb pom tuaj yeem ua pov thawj peb cov txiaj ntsig uas peb pom tias siv cystatin C tuaj yeem pab ntes cov neeg mob ntshav qab zib tsawg hauv lub raum thaum ntxov thaum GFR nyob nruab nrab ntawm 60 thiab 89 mL / min / 1.73 m2.

Raws li Kev Tshawb Fawb Kev Noj Qab Haus Huv thiab Kev Noj Qab Haus Huv Hauv Tebchaws Thib Peb (NHANES III), peb txoj kev tshawb fawb tau pom tias qib ntawm cov ntshav cystatin C siab dua hauv cov menyuam yaus piv rau cov neeg laus [33] thiab muaj ntau dua rau cov txiv neej piv rau cov poj niam hauv txhua pab pawg hnub nyoog [34] , 35] ib. Ntawm qhov tod tes, Norlund et al. tsis pom qhov sib txawv ntawm cystatin C qib ntawm poj niam txiv neej [36]. Cov kev tsis sib xws no yuav raug piav qhia los ntawm cov hnub nyoog sib txawv ntawm pawg neeg kawm: lub hnub nyoog nruab nrab ntawm peb pawg neeg mob ntshav qab zib yog 16.2 xyoo, thaum Norlund li al. suav nrog cov neeg laus noj qab haus huv uas muaj hnub nyoog tshaj 20 xyoo.

Ib qho kev sib raug zoo tsis zoo ntawm cov ntshav cystatin C thiab HbA1c tau pom nyob rau hauv peb qhov kev tshawb nrhiav, uas tau pom zoo nrog SEARCH rau Diabetes hauv Kev Kawm Tub Ntxhais Hluas thiab cov txiaj ntsig los ntawm Maahs li al. txoj kev tshawb fawb [13,35], txawm li cas los xij, qhov tseem ceeb ntawm cov no. kev tshawb pom hauv kev kho mob tseem tsis tau meej. Tsis tas li ntawd, peb txoj kev tshawb fawb tau pom qhov sib txawv tsis zoo ntawm cystatin C thiab HDL cholesterol. Qib HDL qis yog siv los ua ib qho ntawm cov txheej txheem rau kev kuaj mob ntawm metabolic syndrome [37]. Ib txoj kev tshawb nrhiav ntu ntu ntawm 925 cov neeg mob dyslipidemic tau pom tias muaj kev nce qib hauv cystatin C nrog cov khoom noj metabolic ntau ntxiv [38]. Cov neeg mob uas muaj qib siab dua ntawm cystatin C tau pom tias muaj kev pheej hmoo ntau dua ntawm cov kab mob plawv txawm tias tom qab kho ntau yam ntawm cov neeg muaj peev xwm confounders [39]. Kev tshuaj ntsuam meta tsis ntev los no ntawm ntau dua 22,{11}} cov neeg koom los ntawm 14 cov kev tshawb fawb pom tau tias ntau dua cystatin C qib tau muaj zog thiab nws tus kheej cuam tshuam nrog cov ntsiab lus tshwj xeeb xws li mob stroke, myocardial infarction, thiab lub plawv tsis ua haujlwm [40].

Ib qho kev txwv ntawm peb txoj kev tshawb fawb yog tias peb tsis ntsuas GFR raws li nws tau suav tias yog qhov kev ntsuam xyuas zoo tshaj plaws ntawm lub raum ua haujlwm [41]. Txawm li cas los xij, nws yuav nyuaj rau kev kho mob thiab kev coj ncaj ncees, tshwj xeeb tshaj yog nyob rau hauv cov menyuam yaus, vim tias nws yuav tsum tau txhaj tshuaj ntawm cov cim pom. Yog li, feem ntau ntawm cov kev tshawb fawb niaj hnub siv kwv yees GFR qib rau kev ntsuam xyuas ntawm lub raum kev ua haujlwm, tsis hais hauv menyuam yaus lossis cov neeg laus [41].

Lwm qhov kev sib tw uas peb txoj kev tshawb fawb tau ntsib yog qhov tsis muaj qhov tseem ceeb ntawm cov menyuam yaus rau cov ntshav cystatin C. Txawm li cas los xij, qhov no yog qhov teeb meem thoob ntiaj teb, txawm tias feem ntau siv biomarkers, xws li neutrophil gelatinase-associated lipocalin, raum raug mob molecule-I, thiab. cov ntshav cystatin C, muaj qhov tsis txaus siv qhov tseem ceeb hauv cov menyuam yaus [28].

5. Cov lus xaus

Serum cystatin C ntxiv qhov tseem ceeb rau kev kuaj mob raum thaum ntxov, raws li peb txoj kev tshawb fawb pom tias nws tuaj yeem siv tau zoo rau cov neeg mob hluas nrog T1D rau kwv yees GFR. Txhawm rau ntsuas qhov tseeb ntawm tus nqi ntawm cystatin C, peb xav tau kev tshawb fawb ntxiv ntawm cov tub ntxhais hluas T1D cov neeg mob txhawm rau txheeb xyuas cov neeg uas yuav mob ntshav qab zib raum.

Tus sau kev koom tes:Kev Tshawb Fawb, Kev Tshawb Fawb Txog Kev Tshawb Fawb, Sau Cov Qauv Tseem Ceeb, IS; Kev tshawb nrhiav, tshuaj xyuas thiab kho cov ntawv sau, LR; Kev txheeb cais, AM; Kev Tshawb Fawb, RD, thiab ED; Kev Tshawb Fawb Txog Kev Tshawb Fawb, Kev Tshawb Fawb thiab Kho Cov Ntawv Qhia, RV Txhua tus kws sau ntawv tau nyeem thiab pom zoo rau cov ntawv luam tawm ntawm cov ntawv sau.

Nyiaj txiag:Txoj kev tshawb fawb no tau txais kev txhawb nqa los ntawm Lithuanian Research Council, Kev Tshawb Fawb thiab Kev Txhim Kho No. CH{{0}ŠMM-01/09.

Institutional Review Board Statement:Txoj kev tshawb no tau pom zoo los ntawm Lithuanian National Ethical Committee (No. BE-2-5/2013) thiab sau ntawv tso cai tau txais los ntawm txhua tus neeg koom nrog kev kawm thiab lawv niam lawv txiv lossis cov neeg saib xyuas raug cai. Kev tshawb nrhiav tau ua los ntawm Kev Tshaj Tawm ntawm Helsinki.

Cov Lus Qhia Txog Kev Pom Zoo:Cov ntaub ntawv tso cai tau txais los ntawm txhua tus neeg laus thiab cov neeg sawv cev raug cai rau cov menyuam yaus koom nrog hauv txoj kev kawm.

Cov ntaub ntawv muaj nyob:Tag nrho cov ntaub ntawv tsim los yog tshuaj xyuas thaum lub sijhawm kawm no suav nrog hauv tsab xov xwm no.

Kev tsis sib haum xeeb ntawm kev txaus siab:Cov kws sau ntawv tshaj tawm tias lawv tsis muaj kev nyiam sib tw.

Cov ntaub ntawv

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