scholarly journals Elevation of Serum Cystatin C Levels as a Predictor of Cardiovascular Risk in Type 2 Diabetes Mellitus Patients: A Case-control Study

2021 ◽  
Author(s):  
NS Sumantara ◽  
MR Anusuya
Keyword(s):  
Cardiovascular Risk ◽  
Lipid Profile ◽  
Cystatin C ◽  
Serum Levels ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Type 2 Diabetic Patients ◽  
Serum Cystatin ◽  
Type 2 Dm

Introduction: Patients with type 2 Diabetes Mellitus (DM) exhibit atherogenic lipid profile, increasing the risk for atherosclerosis, compared to people without diabetes. Cystatin C, a naturally occurring protease inhibitor has a key role in pathogenesis of atherosclerosis in type 2 DM patients by inhibiting the elastolytic activity of arterial extracellular matrix by cysteine protease cathepsins. Increased concentration of cystatin C in serum reflects a counterbalance of the damaging elastolytic activity which is involved in the pathogenesis of atherosclerosis in type 2 DM patients. Aim: To determine the serum levels of cystatin C and lipid profile in type 2 DM patients with good and poor glycaemic control and to find out the correlation between serum cystatin C with HbA1c levels and cardiovascular risk markers (non-High-Density Lipoprotein Cholesterol (HDLc), Total Cholesterol (TC)/HDLc, Low-Density Liporotein (LDLc)/HDLc). Materials and Methods: The present case-control study included 60 diabetic patients of 35-75 years of age including both the genders. They were divided into Group A (n=30) with HbA1c ≤6.5% and Group B (n=30) with HbA1c >6.5%. Blood samples were collected in fasting state and analysed for Fasting Blood Sugar (FBS), TC, HDLc, LDLc. FBS was analysed by Hexokinase method, HbA1c by turbidimetric inhibition immunoassay and cystatin C by Immunoturbidimetric method. Other parameters like Non-HDLc and cardiovascular risk ratios TC/HDLc and LDLc/HDLc were calculated. Statistical analysis was done by student’s t-test and statistical significance was established at p-value <0.0001. Pearson’s correlation coefficient was used to examine various parameters. Results: In the present study, it was found that diabetic patients with HbA1c >6.5% showed increased levels of serum cystatin C (1.20±0.73 mg/L), TC (182±46.48 mg/dL), LDLc (137±13.86 mg/dL) and low levels of HDLc (34.7±12.43 mg/dL) compared to diabetic patients with HbA1c ≤6.5%. Increase in serum cystatin C levels correlated well with the increased levels of HbA1c (r=0.92), non-HDLc (r=0.87) and cardiovascular risk ratios like TC/HDLc (r=0.95) and LDLc/HDLc (r=0.97). Conclusion: The elevated serum levels of cystatin C levels correlated well with increased HbA1c and lipid profile indicating the dyslipidemia and proatherogenic status in type 2 diabetic patients with poor glycaemic control. Thus, cystatin C can be considered as the predictive marker for cardiovascular disease in type 2 diabetic patients.

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

2015 ◽  
Vol 18 (1) ◽  
pp. 87-93 ◽  
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.

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
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

Association between serum cystatin C levels and cardiovascular disease in type 2 diabetic patients

2013 ◽  
Vol 71 (4) ◽  
pp. 438-442
Author(s):  
Sonia Triki ◽  
Ons Fekih ◽  
Ilhem Hellara ◽  
Fadoua Neffati ◽  
Wahiba Douki ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cystatin C ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Type 2 Diabetic Patients ◽  
Serum Cystatin ◽  
Type 2 Diabetic

Assessment of serum cystatin C level in type 2 diabetic patients with early carotid atherosclerosis

2021 ◽  
Vol 24 (05) ◽  
Author(s):  
Ahmad Saad Abbas ◽  
Abdulkareem H. Issa ◽  
Abbas Mahdi Rahmah ◽  
Ahmed Al-Sabbagh
Keyword(s):  
Cystatin C ◽  
Carotid Atherosclerosis ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Type 2 Diabetic Patients ◽  
Serum Cystatin ◽  
Type 2 Diabetic

STUDY OF RENAL FUNCTION IN TYPE 2 DIABETIC PATIENTS BY SERUM CYSTATIN C

2017 ◽  
pp. 44-51
Author(s):  
Anh Dao Dang ◽  
Huu Dang Tran
Keyword(s):  
Glomerular Filtration Rate ◽  
Cystatin C ◽  
Filtration Rate ◽  
Control Group ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Type 2 Diabetic Patients ◽  
Serum Cystatin ◽  
Type 2 Diabetic

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

Relationship between serum cystatin C and serum adiponectin level in type 2 diabetic patients

2011 ◽  
Vol 16 (3) ◽  
pp. 399-405 ◽  
Author(s):  
Yoshiya Hosokawa ◽  
Yuya Yamada ◽  
Yoshinari Obata ◽  
Megu Yamaguchi Baden ◽  
Kenji Saisho ◽  
...  
Keyword(s):  
Cystatin C ◽  
Adiponectin Level ◽  
Serum Adiponectin ◽  
Diabetic Patients ◽  
Serum Adiponectin Level ◽  
Serum Cystatin C ◽  
Type 2 Diabetic Patients ◽  
Serum Cystatin ◽  
Type 2 Diabetic

scholarly journals Effect of serum cystatin C in early diabetic nephropathy in type 2 Iraqi diabetic patients

2017 ◽  
Vol 3 (10) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cystatin C ◽  
Significant Positive Correlation ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Albumin Excretion

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.

scholarly journals Assessment of Cystatin C and Microalbumin as Biomarkers for Nephropathy in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 10 (25) ◽  
pp. 1866-1870
Author(s):  
Bhuneshwar Yadav ◽  
Shashidhar K.N ◽  
Raveesha A ◽  
Muninarayana C.
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Cystatin C ◽  
Elevated Serum ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Serum Cystatin

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

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