Value Analysis of the Combined Detection of Cystatin C, Hypersensitive C-reactive protein and Urinary Microalbumin in the Diagnosis of Early Renal Damage in Diabetes

To explore the value of combined detection of cystatin C, high sensitivity C-reactive protein and microalbuminuria in the diagnosis of early diabetic renal damage. From September 2016 to May 2018, 96 patients with type 2 diabetes were selected and divided into three groups according to the staging criteria of renal damage caused by diabetes: simple diabetes group (32 cases), early diabetic nephropathy group (32 cases) and clinical diabetic nephropathy group (32 cases). Another 32 healthy people in the same period were selected as the control group. Fasting venous blood and urine were collected to detect microalbuminuria, urine microalbuminuria, serum cystatin C and hypersensitive C-reactive protein. The sensitivity and specificity of three detection indexes were analyzed by receiver operating characteristic curve. Compared with the control group, the levels of cystatin C, high sensitivity C-reactive protein and microalbuminuria in the simple diabetic group, the early diabetic nephropathy group and the clinical diabetic nephropathy group were significantly increased (p<0.05); the levels of cystatin C, high sensitivity C-reactive protein and microalbuminuria in the early diabetic nephropathy group and the clinical diabetic nephropathy group were significantly higher than those in the simple diabetic group (p<0.05).In the early diabetes group, the positive rates of cystatin C, high sensitivity C-reactive protein and microalbuminuria were lower than those of combined detection, and the difference was statistically significant (p<0.05). Receiver operating characteristic curve analysis showed that the Area under the curve of microalbuminuria, whole blood high sensitivity C-reactive protein, serum cystatin C and diagnosis of early diabetic nephropathy were 0.960, 0.934 and 0.929 respectively, with high accuracy. The AUC of combined detection of the three indicators was 0.994, with sensitivity and specificity of 100.00 % and 99.70 %. The combined detection of high sensitivity C-reactive protein, microalbuminuria and serum cystatin C can improve the sensitivity and specificity of diagnosis of early diabetic nephropathy, which is of great significance for clinical prevention and treatment of early diabetic nephropathy and progression to end-stage renal disease.