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One hundred and sixty-eight patients with T2DM and 56 healthy volunteers (control group) were enrolled at Shandong University Qilu Hospital between April 2010 and October 2012. All subjects underwent blood sampling for sera homocysteine (Hcy) and cystatin C (Cys C) assays and a urine microalbumin test. The patients were divided into three groups according to the urine microalbumin excretion rate (UMAER): the simple DM group (SDM group, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>51<\/mml:mn><\/mml:math>), the early-stage DN group (EDN group, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>60<\/mml:mn><\/mml:math>), and the clinical DN and renal failure group (CDN group, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>57<\/mml:mn><\/mml:math>). Correlation analysis was performed to examine the association between sera Hcy and Cys C levels with UMAER. Our findings showed that sera Hcy level, Cys C level, and UMAER increased significantly in the SDM group (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.05<\/mml:mn><\/mml:math>, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:math>), the EDN group (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:math>), and the CDN group (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:math>) as compared with the control group. These three biochemical markers also increased significantly with DN progression (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:math>). Correlation analysis showed that sera Hcy and Cys C levels were positively correlated with UMAER (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\"><mml:mi>r<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.702<\/mml:mn><\/mml:math>, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:math>; <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\"><mml:mi>r<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.873<\/mml:mn><\/mml:math>, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:math>). In conclusion, our results showed that sera Hcy and Cys C levels increased consistently with the development and progression of DN as indicated by UMAER. Sera Hcy and Cys C are sensitive biomarkers for the detection of early-stage DN and monitoring its progression.<\/jats:p>","DOI":"10.1155\/2013\/407452","type":"journal-article","created":{"date-parts":[[2013,9,18]],"date-time":"2013-09-18T21:02:31Z","timestamp":1379538151000},"page":"1-5","source":"Crossref","is-referenced-by-count":17,"title":["Diagnostic Value of the Combined Measurement of Serum Hcy, Serum Cys C, and Urinary Microalbumin in Type 2 Diabetes Mellitus with Early Complicating Diabetic Nephropathy"],"prefix":"10.1155","volume":"2013","author":[{"given":"Tengkai","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine, Taishan Medical College, Tai\u2019an, China"},{"name":"Department of Clinical Medicine, Shandong University School of Medicine, Ji\u2019nan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Shandong University Qilu Hospital, Ji\u2019nan 250012, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhimei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Third People\u2019s Hospital, Ji\u2019nan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zuomin","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ji\u2019nan Iron and Steel Group Corporation General Hospital, Ji\u2019nan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lunqin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Third People\u2019s Hospital, Ji\u2019nan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"issue":"10","key":"1","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1007\/s00108-012-3129-z","volume":"53","year":"2012","journal-title":"Internist"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1007\/s00108-010-2761-8"},{"issue":"9","key":"3","first-page":"897","volume":"70","year":"2012","journal-title":"Kardiologia Polska"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2009.02.009"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-007-0245-7"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307084176"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2261-8-1"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2007.03.008"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfp024"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2008.10.042"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.03.059"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2009.01147.x"},{"key":"13","first-page":"320","volume":"63","year":"2005","journal-title":"Nihon Rinsho Geka Gakkai Zasshi"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-011-0525-y"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2012.06.024"},{"issue":"3","key":"16","first-page":"394","volume":"21","year":"2012","journal-title":"Asia Pacific Journal of Clinical Nutrition"},{"issue":"4","key":"17","first-page":"495","volume":"59","year":"2012","journal-title":"Acta Biochimica Polonica"},{"issue":"3","key":"18","first-page":"279","volume":"32","year":"2002","journal-title":"Annals of Clinical and Laboratory Science"},{"issue":"12","key":"19","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1038\/nrneph.2010.142","volume":"6","year":"2010","journal-title":"Nature Reviews. 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