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Abstract
Background
Recent studies suggest that serum Cystatin C is both a sensitive marker for renal dysfunction and a predictive marker for cardiovascular diseases. We aimed to evaluate the association between Cystatin C and various biomarkers and to find out its utility in estimating risk for cardiovascular diseases in type 2 diabetic patients.
Methods
From June 2006 to March 2008, anthropometric measurements and biochemical studies including biomarkers for risk factors of cardiovascular diseases were done in 520 type 2 diabetic patients. A 10-year risk for coronary heart diseases and stroke was estimated using Framingham risk score and UKPDS risk engine.
Results
The Independent Variables Showing Statistically Significant Associations With Cystatin C Were Age (β = 0.009, P < 0.0001), Hemoglobin (β = -0.038, P = 0.0006), Serum Creatinine (β = 0.719, β < 0.0001), Uric Acid (β = 0.048, P = 0.0004), Log Hscrp (β = 0.035, P = 0.0021) And Homocysteine (β = 0.005, P = 0.0228). The Levels Of Microalbuminuria, Carotid Intima-media Thickness, Fibrinogen And Lipoprotein (A) Also Correlated With Cystatin C, Although The Significance Was Lost After Multivariate Adjustment. Calculated Risk For Coronary Heart Diseases Increased In Proportion To Cystatin C Quartiles: 3.3 ± 0.4, 6.2 ± 0.6, 7.6 ± 0.7, 8.4 ± 0.7% From Framingham Risk Score (P < 0.0001); 13.1 ± 0.9, 21.2 ± 1.6, 26.1 ± 1.7, 35.4 ± 2.0% From Ukpds Risk Engine (P < 0.0001) (Means ± Se).
Conclusions
Cystatin C is significantly correlated with various emerging biomarkers for cardiovascular diseases. It was also in accordance with the calculated risk for cardiovascular diseases. These findings verify Cystatin C as a valuable and useful marker for predicting future cardiovascular diseases in type 2 diabetic patients.
Figures and Tables
Fig. 1
Cystatin C values according to the history of CAD (coronary artery disease). Data are means ± SE. *P = 0.039 vs CAD (-).
Fig. 2
10-year risk of cardiovascular diseases estimated by UKPDS risk engine (A, B, C, D) and Framingham risk score (E), according to Cystatin C (mg/L) quartile (Q1 < 0.81, 0.81 ≤ Q2 < 1.01, 1.01 ≤ Q3 < 1.33, 1.33 ≤ Q4). Data are means ± SE. *P < 0.05 vs Q1, †P < 0.05 vs Q2, ‡P < 0.05 vs Q3.
Table 1
Baseline characteristics according to Cystatin C quartiles
Data are expressed as mean ± SD or %. ACR, albumin-creatinine ratio; BMI, body mass index; BP, blood pressure; CAD, coronary artery disease; DM, diabetes mellitus; HC, hip circumference; hsCRP, high-sensitive C-reactive protein; IMT, intima-media thickness; PAI-1, plasminogen activator inhibitor-1; TSH, thyroid stimulating hormone; WC, waist circumference; WHR, waist-hip ratio. *P < 0.05 vs Q1, †P < 0.05 vs Q2, ‡P < 0.05 vs Q3.
Table 2
Correlation between Cystatin C and other variables
*Adjusted for age. ACR, albumin-creatinine ratio; BMI, body mass index; BP, blood pressure; CAD, coronary artery disease; DM, diabetes mellitus; HC, hip circumference; hsCRP, high-sensitive C-reactive protein; IMT, intima-media thickness; PAI-1, plasminogen activator inhibitor-1; TSH, thyroid stimulating hormone; WC, waist circumference; WHR, waist-hip ratio.
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