Serum cystatin C levels are associated with asymptomatic peripheral arterial disease in type 2 diabetes mellitus patients without overt nephropathy.
OBJECTIVE
We investigated the association between serum cystatin C and asymptomatic peripheral artery disease (PAD) in type 2 diabetes mellitus patients with normal renal function or mild renal impairment and we compared cystatin C with albuminuria and estimated glomerular filtration rate (eGFR) for prediction of PAD.


METHODS
We enrolled 272 patients with type 2 diabetes. Patients were excluded if they had an eGFR<60mL/min per 1.73m(2), 24-h urine albumin (24h-uAlb)≥300mg/day, serum creatinine (Cr)>1.3mg/dL, or previous history of cardiovascular disease. PAD was defined as having an ankle brachial index (ABI)≤0.9.


RESULTS
Patients with PAD were more likely to have a lower eGFR and higher values of 24h-uAlb, cystatin C, and serum Cr than subjects without PAD. Cystatin C was independently associated with age, current smoking, HDL, eGFR, and PAD. Odds ratios (ORs) for PAD after adjustment for age, gender, smoking, and hypertension were 1.71 (95% CI, 1.02-2.85), 1.51 (95% CI, 0.93-2.44), and 0.78 (95% CI, 0.41-1.49) for a one standard deviation increase in cystatin C, 24h-uAlb, and eGFR, respectively.


CONCLUSIONS
Cystatin C was independently associated with PAD in type 2 diabetes mellitus patients without overt nephropathy.
Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju-Si, Republic of Korea.
Ji Hye
JH
Huh
Institute of Lifestyle Medicine, Yonsei University, Wonju College of Medicine, Wonju-Si, Republic of Korea.
EunHee
E
Choi
Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju-Si, Republic of Korea.
Jung Soo
JS
Lim
Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju-Si, Republic of Korea.
Mi Young
MY
Lee
Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju-Si, Republic of Korea.
Choon Hee
CH
Chung
Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju-Si, Republic of Korea. Electronic address: sjy3290@yonsei.ac.kr.
Jang Yel
JY
Shin
D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D055109:Ankle Brachial Index; D058070:Asymptomatic Diseases; D055316:Cystatin C / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000097:blood* / Q000175:diagnosis; D003928:Diabetic Nephropathies / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000097:blood* / Q000209:etiology
D055316:Cystatin C
Cystatin C; Peripheral arterial disease; Renal impairment; Type 2 diabetes