title: Cystatin C as an early biomarker of nephropathy in patients with type 2 diabetes.
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 m(2) estimated by MDRD equation in patients with normoalbuminuria. On the other hand, eGFR < 60 mL/min/1.73 m(2) 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.
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Yun Kyung
authors.initials: YK
authors.lastname: Jeon
authors.forename: Mi Ra
authors.initials: MR
authors.lastname: Kim
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Huh
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Mok
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Song
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Kim
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Kim
authors.forename: Soo Hyoung
authors.initials: SH
authors.lastname: Lee
authors.forename: Yong Ki
authors.initials: YK
authors.lastname: Kim
authors.forename: In Joo
authors.initials: IJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003404:Creatinine / Q000097:blood / Q000652:urine; D055316:Cystatin C / Q000097:blood / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000503:physiopathology / Q000652:urine*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D003404:Creatinine