title: Does serum cystatin C level reflect insulin resistance in patients with type 1 diabetes?
abstract: OBJECTIVE
  The aim of study was to evaluate the relationship between serum cystatin C and insulin resistance (IR) in type 1 diabetic patients being the participants of Poznan Prospective Study.
  
  
  METHODS
  The study was performed on 71 Caucasian patients (46 men); with type 1 diabetes, who were recruited into the Poznan Prospective Study, at the age of 39±6.1 meanly, and treated with intensive insulin therapy since the onset of the disease. The follow-up period and diabetes duration were 15±1.6 years. Insulin resistance (IR) was assessed by estimated glucose disposal rate (eGDR) calculation with cut-off point 7.5 mg/kg/min. Patients were divided into two groups, according to the presence or absence of IR.
  
  
  RESULTS
  From among 71 patients, 31 patients (43.7%) presented decreased sensitive to insulin with eGDR below 7.5 mg/kg/min. Patients who had eGDR <7.5 mg/kg/min (insulin resistant), compared with subjects with eGDR >7.5 mg/kg/min (insulin sensitive), had higher level of serum cystatin C [0.59 (IQR:0.44-0.84) vs 0.46 (IQR:0.37-0.55) mg/L, p=0.009]. A significant negative correlation between cystatin C and eGDR was revealed (Rs=-0.39, p=0.001). In regression model cystatin C was related to insulin resistance, adjusted for sex, BMI, eGFR and duration of diabetes [OR 0.03 (0.001-0.56), p=0.01].
  
  
  CONCLUSIONS
  Higher level of serum cystatin C is related to decreased insulin sensitivity in patients with type 1 diabetes. This relationship seems to have an important clinical implication.
authors: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Mickiewicza 2, 60-834 Poznan, Poland. Electronic address: aleksandrauruska@gmail.com.
authors: A
authors: A
authors: Uruska
authors: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Mickiewicza 2, 60-834 Poznan, Poland.
authors: A
authors: A
authors: Araszkiewicz
authors: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Mickiewicza 2, 60-834 Poznan, Poland.
authors: D
authors: D
authors: Zozulinska-Ziolkiewicz
authors: Lipid Metabolism Laboratory, Department of General Chemistry, Chemistry and Clinical Biochemistry, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland.
authors: M
authors: M
authors: Wegner
authors: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Mickiewicza 2, 60-834 Poznan, Poland.
authors: A
authors: A
authors: Grzelka
authors: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Mickiewicza 2, 60-834 Poznan, Poland.
authors: B
authors: B
authors: Wierusz-Wysocka
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism / Q000502:physiology; D055316:Cystatin C / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology*; D005260:Female; D005947:Glucose; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D044465:White People
chemical_list: D001786:Blood Glucose; D055316:Cystatin C; D007328:Insulin; D005947:Glucose
keywords: Cystatin C; Estimated glucose disposal rate; Insulin resistance; Intensive insulin therapy; Type 1 diabetes