Cystatin C: A Strong Marker for Lower Limb Ischemia in Chinese Type 2 Diabetic Patients?

AbstractThe present study aimed to evaluate the characteristic influence of physical therapeutic procedures of vacuum-compression therapy (VCT) on microvascular perfusion (MiP) and macrovascular perfusion (MaP) of the lower limb in diabetic patients. A sample of nine patients with a medical history of type 2 diabetes was used for the purpose of this study. Most of the subjects’ medical conditions included venous and neurological complications of the lower limb, whereas the rest of the subjects entered the treatment due to injury recovery or their phlebological disease. The PeriFlux System 5000 (Perimed, Sweden) diagnostic device was used to measure MiP. The MaP was evaluated based on the perfusion index (PI) using the Extremiter monitoring device (Embitron, Czech Republic) designed to perform VCT procedures. The study found that MiP and MaP increase as an effect of VCT procedures and at the same time PI clearly reflects the effect of the applied vacuum and compression phases, verifying the method’s vital influence on peripheral perfusion disorders.

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Cystatin C and collagen type IV in diagnostics of chronic kidney disease in type 2 diabetic patients

Diabetes Mellitus ◽

10.14341/dm2015187-93 ◽

2015 ◽

Vol 18 (1) ◽

pp. 87-93 ◽

Cited By ~ 3

Author(s):

Vadim Valer'evich Klimontov ◽

Nadezhda Valentinovna Eremenko ◽

Natalya Evgen'evna Myakina ◽

Olga Nikolaevna Fazullina

Keyword(s):

Cystatin C ◽

Collagen Type ◽

Collagen Type Iv ◽

Diabetic Patients ◽

Serum Cystatin C ◽

Type 2 Diabetic Patients ◽

Serum Cystatin ◽

Type Iv ◽

Type 2 Diabetic

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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Cystatin C is a more sensitive marker than creatinine for the estimation of GFR in type 2 diabetic patients

Kidney International ◽

10.1046/j.1523-1755.2002.00253.x ◽

2002 ◽

Vol 61 (4) ◽

pp. 1453-1461 ◽

Cited By ~ 148

Author(s):

Michele Mussap ◽

Michele Dalla Vestra ◽

Paola Fioretto ◽

Alois Saller ◽

Mariacristina Varagnolo ◽

...

Keyword(s):

Cystatin C ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic ◽

Sensitive Marker

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Adherence to guideline recommended medical therapies in type 2 diabetic patients with chronic critical limb ischemia

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2019.107898 ◽

2019 ◽

Vol 158 ◽

pp. 107898 ◽

Cited By ~ 2

Author(s):

Elisabetta Iacopi ◽

Alberto Coppelli ◽

Nicola Riitano ◽

Lorenza Abbruzzese ◽

Letizia Pieruzzi ◽

...

Keyword(s):

Critical Limb Ischemia ◽

Limb Ischemia ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Chronic Critical Limb Ischemia ◽

Medical Therapies ◽

Type 2 Diabetic

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Predictors of major lower limb amputation in type 2 diabetic patients referred for hospital care with diabetic foot syndrome

Diabetes Metabolic Syndrome and Obesity Targets and Therapy ◽

10.2147/dmso.s165967 ◽

2018 ◽

Vol Volume 11 ◽

pp. 313-319 ◽

Cited By ~ 11

Author(s):

Nawaf J Shatnawi ◽

Nabil A Al-Zoubi ◽

Hassan M Hawamdeh ◽

Yousef S Khader ◽

Khaled Gharaibeh ◽

...

Keyword(s):

Lower Limb ◽

Diabetic Foot ◽

Hospital Care ◽

Lower Limb Amputation ◽

Diabetic Foot Syndrome ◽

Limb Amputation ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

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Migratory Activity of Circulating Mononuclear Cells Is Associated With Cardiovascular Mortality in Type 2 Diabetic Patients With Critical Limb Ischemia

Diabetes Care ◽

10.2337/dc13-2084 ◽

2014 ◽

Vol 37 (5) ◽

pp. 1410-1417 ◽

Cited By ~ 10

Author(s):

Gaia Spinetti ◽

Claudia Specchia ◽

Orazio Fortunato ◽

Elena Sangalli ◽

Giacomo Clerici ◽

...

Keyword(s):

Cardiovascular Mortality ◽

Critical Limb Ischemia ◽

Mononuclear Cells ◽

Limb Ischemia ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Migratory Activity ◽

Type 2 Diabetic

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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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Serum Cystatin C in Type 2 Diabetic Patients with Early Renal Damage

Myanmar Health Sciences Research Journal ◽

10.34299/mhsrj.00937 ◽

2019 ◽

Vol 31 (2) ◽

pp. 137-142

Keyword(s):

Cystatin C ◽

Renal Damage ◽

Diabetic Patients ◽

Serum Cystatin C ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Female Ratio ◽

Mean Values ◽

Type 2 Diabetic

Diabetic nephropathy is one of the most common complications in diabetes mellitus (DM). The ability to assess renal function in diabetes patients rapidly and early is of major importance. Nowadays, cystatin C (cys C) is introduced as a new marker for diagnosis of early renal damage. The purpose of this study was to study serum cys C in type 2 diabetic patients with early renal damage. This is a hospital-based, cross-sectional analytical study involving 50 cases of type 2 diabetic patients attending the Diabetic Clinic of Mandalay General Hospital. In this study, most cases were females with male to female ratio of 1:2. Mean age was 59±11.9. Mean values of serum cys C, albumim creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) were 0.89±0.37 mg/l, 18.46±16.47 mg/g and 92.34±22.63 ml/min, respectively. In this study, 60% of cases were eGFR 60-90 ml/min and 40% of cases were eGFR >90 ml/min. And then, 82% of cases were normoalbuminuria and 18% of cases were microalbuminuria. Serum cys C was negatively correlated with eGFR (r=-0.0235, p=0.1) and positively correlated with urine for ACR (r=0.177, p=0.219). In addition, serum cys C was positively correlated with normoalbuminuria (r=0.188, p=0.238) and negatively correlated with microalbuminuria (r=-0.008, p=0.984). But these are not statistically significant. Therefore, this study is concluded that serum cys C was higher in both normoalbuminuric and microalbuminuric type 2 diabetic patients. The correlations of serum cys C with microalbuminuria and normoalbuminuria were not statistically significant. Therefore, it is controversial to say that serum cys C can be used as early detection marker of renal damage in type 2 diabetic patients in this study.

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