Serum Cystatin C as Well as Urinary Albumin-Creatinine Ratio Is Associated with Carotid Artery Intima-Media Thickness (IMT) in Korean Type 2 Diabetic Patients

Aim. To compare kidney disease markers: glomerular filtration rate (GFR), calculated upon creatinine and cystatin C, urinary cystatin C, collagen type IV and albumin in type 2 diabetic patients with normal and moderately reduced renal function. Materials and methods. 56 patients, aged 43?70 years, and 16 healthy controls, aged 40-72 years, were included in the study. GFR was calculated by equations based on creatinine (CKD-EPIcreat), cystatin C (CKD-EPIcys) or both markers (CKD-EPIcreat-cys). Serum and urinary cystatin C was measured by immunoturbidimetric method, urinary albumin, albumin excretion rate (AER) and collagen type IV excretion was determined by ELISA. The body composition was investigated in 24 patients by dual-energy X-ray absorptiometry. Results. In diabetic patients serum cystatin C level correlated positively with age (r=0.37), GFR calculated by CKD-EPIcreat (r=-0.43) and fat mass percentage (r=0.55). There was a positive correlation between GFR calculated by the CKD-EPIcys and GFR by CKD-EPIcreat (r=0.48). In multiple regression analysis the percentage of body fat influenced the GFR calculated by CKD-EPIcys or CKD-EPIcreat-cys. No correlation between urinary cystatin C and serum cystatin C level, GFR and AER was found. Collagen type IV excretion was increased in patients with decreased GFR, compared to those with normal GFR (p=0.002). Urinary collagen type IV correlated with both GFR and AER (r=-0.28 and r=0.47). Conclusion. The measurement of serum cystatin C with calculation of GFR by CKD-EPIcys and CKD-EPIcreat-cys, in addition to the CKD-EPIcreat, increases the accuracy of CKD diagnostics in type 2 diabetic patients. However, obesity and particularly body fat mass affect the results of estimation of GFR based on cystatin C. The increase in urinary collagen type IV, but not in cystatin C excretion, is related to GFR decline and AER elevation in these patients.

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Association between serum cystatin C and diabetic peripheral neuropathy: a cross-sectional study of a Chinese type 2 diabetic population

Acta Endocrinologica ◽

10.1530/eje-14-0381 ◽

2014 ◽

Vol 171 (5) ◽

pp. 641-648 ◽

Cited By ~ 16

Author(s):

Yanyun Hu ◽

Fang Liu ◽

Jing Shen ◽

Hui Zeng ◽

Lianxi Li ◽

...

Keyword(s):

Cross Sectional Study ◽

High Serum ◽

Diabetic Patients ◽

Sectional Study ◽

Serum Cystatin C ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Serum Cystatin ◽

Type 2 Diabetic

ObjectiveSerum cystatin C (CysC) is a sensitive marker of kidney function and recent studies have shown that CysC plays a critical role in degenerative diseases in both the central and the peripheral nervous systems. The aim of this study was to explore the relationship between serum CysC and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes.MethodsIn total, 937 type 2 diabetic patients were enrolled in this cross-sectional study. Serum CysC concentration was measured by immunoturbidimetry. DPN was evaluated by neurological symptoms, neurological signs, neurothesiometer, and electromyogram.ResultsSerum CysC levels were significantly higher in DPN patients (1.3 (1.1–1.5) mg/l) compared with patients with signs of DPN (1.1 (0.9–1.3) mg/l, P<0.001) and non-DPN patients (1.0 (0.9–1.3) mg/l, P<0.001). Multiple regression analysis revealed that DPN was associated with age, diabetes duration, HbA1c, and serum CysC. Spearman's correlation analysis showed that serum CysC was closely related with age, sex, diabetes duration, hypertension, glomerular infiltration rate, and serum creatinine (Cr) level. The patients were divided into quartiles according to the serum CysC levels. Compared with quartile 1 (referent), the risk of DPN was significantly higher in quartile 2 (odds ratio (OR), 1.753; 95% CI, 1.055–2.912; P<0.05), quartile 3 (OR, 2.463; 95% CI, 1.445–4.917; P<0.01), and quartile 4 (OR, 5.867; 95% CI, 2.075–16.589; P<0.01). Receiver-operating characteristic analysis revealed that the optimal cutoff point of serum CysC to indicate DPN was 1.25 mg/l in male patients and 1.05 mg/l in female patients. High serum CysC level indicated a onefold higher risk of DPN.ConclusionsHigh serum CysC level is closely associated with DPN and may be a potential biomarker for DPN in type 2 diabetic patients.

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Serum Cystatin C As An Early Diagnostic Biomarker Of Diabetic Kidney Disease In Type 2 Diabetic Patients

Journal of College of Physicians And Surgeons Pakistan ◽

10.29271/jcpsp.2018.04.288 ◽

2018 ◽

Vol 27 (4) ◽

pp. 288-291 ◽

Cited By ~ 3

Author(s):

Ayesha Qamar ◽

Tariq Mahmood Ahmad ◽

Alamgir Khan ◽

Mohammad Najam ul Hasnat ◽

Sufyan Tahir

Keyword(s):

Kidney Disease ◽

Diabetic Kidney Disease ◽

Diabetic Patients ◽

Diagnostic Biomarker ◽

Serum Cystatin C ◽

Type 2 Diabetic Patients ◽

Serum Cystatin ◽

Type 2 Diabetic ◽

Early Diagnostic

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CORRELATION BETWEEN SERUM CYSTATIN C LEVEL AND RENAL FUNCTION IN PREDIABETES, TYPE 2 DIABETIC PATIENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.5.23 ◽

2017 ◽

pp. 164-173

Author(s):

Anh Dao Dang ◽

Huu Dang Tran

Keyword(s):

Cystatin C ◽

Healthy Subjects ◽

Filtration Rate ◽

Elevated Serum ◽

Diabetic Patients ◽

Serum Cystatin C ◽

Type 2 Diabetic Patients ◽

Serum Cystatin ◽

Type 2 Diabetic

Objectives: To investigate serum Cystatin C level, percentage of elevated serum cystatin C in prediabetic, type 2 diabetic patients. Relationship between serum Cystatin C levels and albuminuria in prediabetes. Correlation between serum Cystatin C levels and estimated glomerular filtration rate (eGFR), renal radiography in type 2 diabetic patients. Materials and methods: 90 healthy subjects, 60 patients with prediabetes, and 124 type 2 diabetic patients were inrolled into this study. We excluded patients with thyroid dysfunction and those taking glucocorticoids that affect the serum Cystatin level. The serum Cystatin C and Creatinine, renal radiography, albuminuria, and eGFR using CKD.EPI, MDRD formular were calculated. Descriptive and cross-sectional study. Analyzed correlation, Receiver operating characteristics (ROC), calculated the area under the curve (AUC) for serum Cystatin C. Results: The level of serum Cystatin C gradually significantly increased in healthy subjects, prediabetes, and type 2 diabetic patients (0.848±0.097; 0.894±0.113; 1.410±0.900 mg/L, p<0.05, respectively). Percentage of elevated serum cystatin C in prediabetic and type 2 diabetic patients were 13%, 47.6%, p<0.05, respectively. There was a positive correlation of serum cystatin C with albuminuria, a negatively correlation between serum Cystatin C level and eGFR in prediabetic subjects.There was a strong positively correlation of eGFR according to CKD.EPI equation based on serum Cystatin C (r=0.804, p < 0.001) and renal radiography (r=0.767, p<0.001). The strong positively correlation between eGFR based on serum Creatinine-Cystatin C and renal radiography (r=0.804, p<0.001). Serum Cystatin C level was significantly negatively correlation with eGFR based on cystatin C serum (r=-0.861, p<0.001) and renal radiography (r=0.739 p<0.001). The cut off value for the identification of GFR < 60ml/min/1.73m2 was 1.53mg/l with a sensitivity of 93.6 (95%CI: 78.3- 96.3) and specificity of 97.4 (95%CI: 88.0- 98.2), AUC was 0.96 according to renal radiography.The cutoff value for the identification of GFR < 60ml/min/1.73m2 was 1.3mg/l with a sensitivity of 100,0 (95%CI: 91.3- 100.0) and specificity of 94.0 (95%CI: 86.5- 98,0), AUC was 0,989 according to CKD.EPI formular based on Cystatin C. Conclusions: The level of serum Cystatin C gradually significantly increased in healthy subjects, prediabetes, and type 2 diabetic patients. There was a correlation of serum cystatin C with albuminuria, eGFR in prediabetic subjects. There was a positive correlation between eGFR based on Cystatin C and renal radiography. A negativelysignificantly correlation between serum Cystatin C level and eGFR,renal radiography. Serum Cystatin C had strong sensitivityand specificity for detecting reduced GFR. Key words: prediabetes, diabetes mellitus, glomerular filtration rate, Cystatin C, albuminuria

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