Serum cystatin C as an indicator for early detection of diabetic nephropathy in type 2 diabetes mellitus

2019 ◽  
Vol 13 (1) ◽  
pp. 374-381 ◽  
Author(s):  
Mohamed Shawky Elsayed ◽  
Ayman El Badawy ◽  
Abdelmon'em Ahmed ◽  
Rasha Omar ◽  
Amr Mohamed
2021 ◽  
Vol 10 (25) ◽  
pp. 1866-1870
Author(s):  
Bhuneshwar Yadav ◽  
Shashidhar K.N ◽  
Raveesha A ◽  
Muninarayana C.

BACKGROUND Increased levels of urinary biomarkers can be detected in type 2 diabetic patients before the onset of significant albuminuria and may be used as an early marker of renal injury in diabetic nephropathy (DN) which would play a significant role for the effective management and treatment approaches in diabetic care. We wanted to evaluate cystatin C and microalbumin as effective early biomarkers in assessing nephropathy in patients with type 2 diabetes mellitus in this study. METHODS A cross-sectional study was conducted among 180 subjects grouped into healthy controls, clinically proven T2DM without nephropathy and type 2 DM with nephropathy comprising 60 participants in each group. Fasting and postprandial blood samples and urine samples were collected and analysed by standard methods. eGFR was calculated using CKD-EPI 2012 equation. IBM - SPSS version 20 was used for statistical analysis. RESULTS Diabetic nephropathy patients had significantly elevated serum cystatin C and microalbumin (2.43 ± 0.59, 700.5 ± 591.8 mg / L, respectively), compared to T2DM (0.98 ± 0.26, 63.7 ± 102.9 mg / L, respectively), and the control study subjects (0.81 ± 0.16, 11.15 ± 8.9 mg / L, respectively). Serum cystatin C showed AUC of 0.994 (95 % CI, 0.986 - 1.00) whereas microalbumin showed 0.944 (95 % CI, 0.907 - 0.981). Serum cystatin C showed a sensitivity of 96.7 % and a specificity of 91.7 % at a cutoff point of 1.34 mg / L whereas at a cut-off point of 138.5 mg / L for microalbumin, the sensitivity and specificity were 90 % and 83.3 % respectively. CONCLUSIONS Serum cystatin C and microalbumin both could be considered as markers for early detection of nephropathy in T2DM patients. The more prominent rise in serum cystatin C values provide an earlier diagnosis of diabetic nephropathy among T2DM patients. KEY WORDS Biomarker, Type 2 Diabetes Mellitus, Cystatin C, Diabetic Nephropathy, Microalbumin


2021 ◽  
Vol 2 (6) ◽  
pp. 2010-2017
Author(s):  
Misnarliah ◽  
Anastasia A. Basir ◽  
Zainuddin

Type 2 diabetes mellitus (DMT2) is associated with atherosclerosis, which causes the disease. cardiovascular and increased mortality. It is still difficult to detect ateroskelerosis in the early stages. Arterial stenosis often develops without symptoms in patients. DMT2, then causes cardiovascular disease. Therefore, development diagnostics to easily detect early-stage atherosclerosis are needed. In this study, we focused on cystatin C serum, an inhibitor of cysteine proteinase. Some research results, it has reported a significant correlation between serum Cystatin C levels and Arterial stiffness in a group of normal individuals. Cystatin C serum has a correlation strong with a value of elasticity of the carotid artery walls that reflect the degree of atherosclerosis subclinical. This is a new sign that is quite potential as a biomarker of early detection atherosclerosis. The purpose of the study is to know the picture serum Cystatin C levels as an early marker to determine the presence of possible complications of atherosclerosis in DMT2 patients, as well as the usefulness of Cystatin-C in predicting atherosclerosis of the early stages. Research methods are analytical research with use cross-sectional design. The study was conducted by calculating the value of Cystatin C blood serum with DMT2. The study subjects were people with DMT2 in RSUD.Labuang Baji Makassarand its network. Sum the sample in this study was 20 people. Determination of the research subject is done by conducting a search on medical records of DMT2 patients who meet the criteria of inclusion and exclusion to achieve minimum number of samples. The study subjects were classified into two groups based on medical record data searches are subclinical atherosclerosis group and nonclinical group ateroskelorosis. The research sample is a serum sample. Serum sample examination is carried out in the Clinical Prodia Laboratory using PENIA method. The results of this study reported the results that Cystatin-C Serum is closely correlated with subclinical atherosclerosis (arterial stiffness. Increase in serum cystatin-C levels indicates the risk of atherosclerosis in Patients with DMT2. The results of this study reported that serum cystatin C levels in dmt2 patients in the nonclinical atherosclerosis group (n = 10) showed normal cystatin levels (0.50 - 0.96 mg/L), while serum Cystatin-C levels in dmt2 group patients showed normal cystatin levels (0.50 - 0.96 mg/L), while serum cystatin-C levels in DMT2 group patients Subclinical atherosclerosis (n = 10) has an increase in serum cystatin-C levels (> 0.90 mg/L). Level cystatin C serum is associated with SA in DMT2 patients. Cystatin C was identified as a predictor of atherosclerosis risk, after adjusting for a variety of factors associated with diabetes.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Suman Sapkota ◽  
Saroj Khatiwada ◽  
Shrijana Shrestha ◽  
Nirmal Baral ◽  
Robin Maskey ◽  
...  

Objectives. Diabetic nephropathy is one of the major complications that develop over time in type 2 diabetes mellitus (T2DM). This prospective study was conducted to assess the diagnostic accuracy of serum cystatin C in detecting diabetic nephropathy at earlier stages. Materials and Methods. This study was undertaken on 50 cases of T2DM and 50 healthy subjects as controls. Demographic and anthropometric data and blood and urine samples were collected. The concentration of serum cystatin C (index test) and traditional markers of diabetic nephropathy, serum creatinine, and urinary microalbumin (the reference standard) were estimated. Similarly, blood glucose, glycated haemoglobin (HbA1c), triglycerides, total cholesterol, high-density lipoprotein (HDL) cholesterol, and urinary creatine were measured. Results. The mean ± SD serum cystatin C was significantly higher in T2DM as compared to control (1.07 ± 0.38 and 0.86 ± 0.12 mg/dl, respectively, p < 0.001 ). The mean ± SD bodyweight, BMI, W : H ratio, pulse, SBP, and DBP were 66.4 ± 12.6 kg, 26.2 ± 5.6 kg/m2, 1.03 ± 0.09, 78 ± 7, 125 ± 16 mm of Hg, and 77 ± 9 mm of Hg, respectively, in cases. A significant difference in HDL cholesterol p = 0.018 and serum cystatin C p < 0.001 was observed among different grades of nephropathy. Cystatin C had a significant positive correlation with age (r = 0.323, p = 0.022 ), duration of T2DM (r = 0.326, p = 0.021 ), and UACR (r = 0.528, p < 0.001 ) and a significant negative correlation with eGFR CKD-EPI cystatin C (r = −0.925, p < 0.001 ). The area under ROC curve for serum cystatin C (0.611, 95% CI: 0.450–0.772) was greater than for serum creatinine (0.429, 95% CI: 0.265–0.593) though nonsignificant. Conclusion. Serum cystatin C concentration increases with the progression of nephropathy and duration of diabetes in Nepalese T2DM patients suggesting cystatin C as a potential marker of renal impairment in T2DM patients.


2017 ◽  
Vol 3 (10) ◽  

Objective This study aimed to find the effect of serum Cystatin C in early diabetic nephropathy.Method This study was conducted in Al Kindy Teaching Hospital during the period from December, 2015 to June, 2016. The study included 90 subjects (30 males and 30 females) with diabetic type 2 and 30 healthy control. Age is between 30 and 70 years. Patients were with no history of liver disease, thyroid or other endocrine diseases through clinical interviewing. They were divided in to three groups. 30 healthy controls, 30 patients with type 2 diabetes mellitus with no albuminuria (albumin excretion in urine <30 μg/ml ) and 30 patients with type 2 diabetes mellitus with micro albuminuria (albumin excretion in urine >30 μg/ml ).Results There were no significant differences in age, body mass index (BMI) among the studied groups (p > 0.05). Serum Cystatin C levels showed significant difference (p < 0.001) among studied groups, it was significantly higher in micro albuminuria than the other two groups. There was highly significant positive correlation between Cystatin C and serum creatinine (r = 0.697, p < 0.001), and a significant negative correlation between Cystatin C and GFR (r = − 0.455, p = 0.011) and show significant positive correlation between Cystatin C and urine albumin (r = 0.526, p = 0.003 ) in type 2 diabetic patients with micro albuminuria.Conclusion Cystatin C is negatively correlated with the amount of GFR, so that Cystatin C considered reliable and sensitive marker for identifyingchanges in GFR. In type 2 diabetes mellitus with micro albuminuria serum Cystatin C level considered predict marker for renal failure.


2009 ◽  
Vol 83 (2) ◽  
pp. e58-e61 ◽  
Author(s):  
Tetsuya Kimura ◽  
Hiroki Ikeda ◽  
Jun Fujikawa ◽  
Kazuhiro Nomura ◽  
Tomohisa Aoyama ◽  
...  

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