Cystatin C as an Early Biomarker of Nephropathy in Patients with Type 2 Diabetes.
10.3346/jkms.2011.26.2.258
- Author:
Yun Kyung JEON
1
;
Mi Ra KIM
;
Jung Eun HUH
;
Ji Young MOK
;
Sang Heon SONG
;
Sang Soo KIM
;
Bo Hyun KIM
;
Soo Hyoung LEE
;
Yong Ki KIM
;
In Joo KIM
Author Information
1. Department of Internal Medicine, Pusan National University Hospital, Busan, Korea. injkim@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Cystatin C;
Diabetic Nephropathies;
Albuminuria
- MeSH:
Aged;
Albuminuria/urine;
*Biological Markers/blood/urine;
Creatinine/blood/urine;
*Cystatin C/blood/urine;
Diabetes Mellitus, Type 2/*blood/physiopathology/*urine;
Diabetic Nephropathies/*blood/physiopathology/*urine;
Female;
Glomerular Filtration Rate;
Humans;
Kidney Function Tests;
Male;
Middle Aged;
ROC Curve;
Retrospective Studies
- From:Journal of Korean Medical Science
2011;26(2):258-263
- CountryRepublic of Korea
- Language:English
-
Abstract:
This study was done to evaluate clinical usefulness of cystatin C levels of serum and urine in predicting renal impairment in normoalbuminuric patients with type 2 diabetes and to evaluate the association between albuminuria and serum/urine cystatin C. Type 2 diabetic patients (n = 332) with normoalbuminuria (n = 210), microalbuminuria (n = 83) and macroalbuminuria (n = 42) were enrolled. Creatinine, urinary albumin levels, serum/urine cystatin C and estimated glomerular filtration rate (eGFR by MDRD [Modification of Diet in Renal Disease] and CKD-EPI [Chronic Kidney Disease Epidemiology Collaboration] equations) were determined. The cystatin C levels of serum and urine increased with increasing degree of albuminuria, reaching higher levels in macroalbuminuric patients (P < 0.001). In multiple regression analysis, serum cystatin C was affected by C-reactive protein (CRP), sex, albumin-creatinine ratio (ACR) and eGFR. Urine cystatin C was affected by triglyceride, age, eGFR and ACR. In multivariate logistic analysis, cystatin C levels of serum and urine were identified as independent factors associated with eGFR < 60 mL/min/1.73 m2 estimated by MDRD equation in patients with normoalbuminuria. On the other hand, eGFR < 60 mL/min/1.73 m2 estimated by CKD-EPI equation was independently associated with low level of high-density lipoprotein in normoalbuminuric patients. The cystatin C levels of serum and urine could be useful markers for renal dysfunction in type 2 diabetic patients with normoalbuminuria.
