title: Association of the novel cardiovascular risk factors paraoxonase 1 and cystatin C in type 2 diabetes.
abstract: Paraoxonase 1 (PON1) has been reported to be associated with proteinuria in subjects with type 2 diabetes mellitus (T2DM). Plasma cystatin C is more accurate than creatinine for identifying stage 3 kidney disease in T2DM. We tested the hypothesis that PON1 and cystatin C would be associated in T2DM subjects from an Aboriginal Canadian community, who are at high risk for the development of nephropathy. PON1 A(-162)G and PON2 Ala148Gly genotypes, cystatin C, HbA1c, high density lipoprotein cholesterol (HDLC), waist circumference (waist), and duration of diabetes were included in the regression analysis with log(e) (ln) of PON1 mass as the dependent variable. A regression model including PON2 Ala148Gly genotype, HDLC, and ln cystatin C explained 25.8% of the variance in PON1 mass. Conversely, waist, age, ln HbA1c, ln duration of diabetes, and ln PON1 mass, but not PON2 genotype, explained 38% of the variance in cystatin C. Subjects with cystatin C estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m(2) (stage 3 kidney disease) had significantly lower PON1 mass compared with subjects with cystatin C-eGFR >60 ml/min per 1.73 m(2). The lower mass of PON1, an anti-inflammatory HDL-associated enzyme, in T2DM with cystatin C-eGFR <60 ml/min per 1.73 m(2) may contribute to their increased risk for cardiovascular disease.
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Canada. connellyp@smh.toronto.on.ca
authors.forename: Philip W
authors.initials: PW
authors.lastname: Connelly
authors.forename: Bernard
authors.initials: B
authors.lastname: Zinman
authors.forename: Graham F
authors.initials: GF
authors.lastname: Maguire
authors.forename: Mary
authors.initials: M
authors.lastname: Mamakeesick
authors.forename: Stewart B
authors.initials: SB
authors.lastname: Harris
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hegele
authors.forename: Ravi
authors.initials: R
authors.lastname: Retnakaran
authors.forename: Anthony J G
authors.initials: AJ
authors.lastname: Hanley
mesh_terms: D000328:Adult; D043303:Aryldialkylphosphatase / Q000097:blood* / Q000235:genetics; D002170:Canada; D002318:Cardiovascular Diseases / Q000097:blood / Q000201:enzymology / Q000209:etiology* / Q000235:genetics; D055316:Cystatin C / Q000097:blood*; D048909:Diabetes Complications / Q000097:blood / Q000201:enzymology / Q000209:etiology* / Q000235:genetics; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000201:enzymology / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D005919:Glomerular Filtration Rate; D006801:Humans; D007198:Indians, North American / Q000235:genetics; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011110:Polymorphism, Genetic; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: C525030:CST3 protein, human; D055316:Cystatin C; D043303:Aryldialkylphosphatase; C468406:PON1 protein, human