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

2017 ◽  
pp. 164-173
Author(s):  
Anh Dao Dang ◽  
Huu Dang Tran

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

2017 ◽  
pp. 44-51
Author(s):  
Anh Dao Dang ◽  
Huu Dang Tran

Aims: to investigate serum Cystatin C level, correlation between serum Cystatin C levels with albuminuria, estimate glomerular filtration rate (eGFR), and renal radiography in type 2 diabetic patients. Materials and methods: We studied 77 healthy subjects without prediabetes or diabetes, and 70 type 2 diabetic patients. We excluded patients with thyroid dysfunction and those taking glucocorticoids that affect the serum Cystatin level. The serum Cystatin C level measured in 2 groups. In type 2 diabetic patients, we measured renal radiography, albuminuria, and estimated GFR using CKD.EPI 2012 formular. Descriptive and cross-sectional study. A statistical analyses of the data was performed using SPSS, Excel 2003. Receiver operating characteristics (ROC) analysis, calculated the area under the curve (AUC) for serum Cystatin C. Results: The level of serum Cystatin C in the type 2 diabetic patients was significantly higher than in the control group (1.45±0.97, 0.97±0.23 mg/L, p<0.001, respectively). The level of serum Cystatin C showed stepwise increase with albuminuria level. The serum cystatin C level in the macroalbuminuria group was significantly higher than microalbuminuria group (2,51±1,13; 1,12±0.69 mg//l, p<0.05, respectively). A positively correlation was observed between eGFR according to CKD.EPI equation based on serum Cystatin C and renal radiography (r=0.710, p<0.001). The positively correlation between eGFR according to CKD.EPI equation based on serum Creatinine-Cystatin C and renal radiography r=0.746, p<0.001). The serum Cystatin C level was significantly higher in patients with GFR < 60 ml/min/1.73m2 than those with ≥ 60 ml/min/1.73m2 (p < 0,001). Serum Cystatin C level was significantly reciprocal correlation between eGFR based on cystatin C serum (r=0.830, p<0.001) or renal radiography (r=0,748, p<0,001). The cutoff value for the identification of GFR < 60ml/min/1.73m2 was 1.28mg/l with a sensitivity of 100.0 (95% CI: 85,6-100,0) and specificity of 95.7 (95%CI:85.1-99.3). AUC was 0,992. Conclusions: The serum cystatin C level in type 2 diabetic patients was significantly higher than the control group. The serum level of Cystatin C in type 2 diabetic patients was stepwise increased with albuminuria level. There was a positive correlation between eGFR based on Cystatin C and renal radiography. A reciprocal correlation between serum Cystatin C level and eGFR calculated by CKD.EPI 2012 formular and GFR by renal radiography. Key words: diabetes, glomerular filtration rate, Cystatin C, albuminuria


2015 ◽  
Vol 18 (1) ◽  
pp. 87-93 ◽  
Author(s):  
Vadim Valer'evich Klimontov ◽  
Nadezhda Valentinovna Eremenko ◽  
Natalya Evgen'evna Myakina ◽  
Olga Nikolaevna Fazullina

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.


2013 ◽  
Vol 71 (4) ◽  
pp. 438-442
Author(s):  
Sonia Triki ◽  
Ons Fekih ◽  
Ilhem Hellara ◽  
Fadoua Neffati ◽  
Wahiba Douki ◽  
...  

2021 ◽  
Vol 24 (05) ◽  
Author(s):  
Ahmad Saad Abbas ◽  
Abdulkareem H. Issa ◽  
Abbas Mahdi Rahmah ◽  
Ahmed Al-Sabbagh

2011 ◽  
Vol 16 (3) ◽  
pp. 399-405 ◽  
Author(s):  
Yoshiya Hosokawa ◽  
Yuya Yamada ◽  
Yoshinari Obata ◽  
Megu Yamaguchi Baden ◽  
Kenji Saisho ◽  
...  

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


2014 ◽  
Vol 171 (5) ◽  
pp. 641-648 ◽  
Author(s):  
Yanyun Hu ◽  
Fang Liu ◽  
Jing Shen ◽  
Hui Zeng ◽  
Lianxi Li ◽  
...  

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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