目的：评估糖尿病视网膜病变(DR)严重程度与血清胱抑素C和急性时相反应指标的相关性，包括红细胞沉降率(ESR)和超敏C反应蛋白(hs-CRP)。

方法：研究纳入了1mo内就诊的所有糖尿病视网膜病患者。患者均记录人口统计学数据。行眼科检查，同时检测糖化血红蛋白(HbA1c)、ESR、hs-CRP和血清胱抑素C水平。

结果：研究包括67例糖尿病患者，其中19例(28.3%)无视网膜病变患者，22例(32.8%)非增殖型视网膜病变患者和26例(38.8%)增殖型视网膜病变患者。三组间平均年龄、性别分布、平均糖尿病病程、高血压和血脂异常患病率、吸烟状况以及HbA1c水平无明显差异。随着视网膜病变发展，平均血清胱抑素C水平显著提高，三组分别为1.1±0.48，1.22±0.38，1.71±0.92(P=0.007)。在多元回归分析中，仅血清胱抑素C与糖尿病视网膜病变严重程度有关(P=0.025)。

结论：研究表明，在独立于急性时相反应指标，血清胱抑素C水平随DR加重升高。因此，该结论可作为初级医护人员区分高危患者的标志。

METHODS: All diabetic patients who were referred for diabetic retinopathy(DR)screening during 1mo were enrolled. Demographic data were recorded. All patients have undergone full ophthalmic exam. At the same day, all patients were tested for hemoglobin A1c(HbA1c), ESR, hs-CRP, and Cys-C serum levels.

RESULTS: Sixty seven diabetics were enrolled, including 19(28.3%)without retinopathy, 22(32.8%)non-proliferative retinopathy, and 26(38.8%)proliferative retinopathy patients. The mean age, sex distribution, mean duration of diabetes, prevalence of hypertension and dyslipidemia, smoking status and HbA1c levels were not significantly different among the three groups. The mean levels of Cys-C increase significantly as retinopathy progress \〖1.1±0.48; 1.22±0.38; 1.71±0.92(P=0.007), respectively\〗. In multiple regression analysis, just Cys-C was significantly associated with severity of DR(P=0.025).

CONCLUSIONS: This study revealed that serum levels of Cys-C increase while DR progress independently of acute phase reactants. Therefore, it could be used as an associated marker by primary care physicians to distinguish patients at higher risk of severe DR. Larger randomized studies are warranted to confirm findings. Reviewing physiological role of the Cys-C, we proposed that the Cys-C may be a protective response to catalytic stress rather than being a pathogenic factor in microangiopathies.