Association of circulating cystatin C levels with type 2 diabetes mellitus: a systematic review and meta-analysis

Abstract

A b s t r a c tIntroduction: This study aimed to systemically summarize the present literature about circulating cystatin C (Cys C) levels in type 2 diabetes mellitus (T2DM) and provide a more precise evaluation of Cys C levels in T2DM. Material and methods: Relevant studies about Cys C concentrations in T2DM were searched in PubMed, EMBASE and the Cochrane Library database (up to Oct 31 2018). We computed the pooled standard mean difference (SMD) with its 95% confidence interval (CI) of Cys C levels through a random-effect model. The Q test and the I 2 statistic were used to assess and quantify between-study heterogeneity; publication bias was evaluated through a funnel plot and Egger's linear regression test. Results: After the literature search and screening process, 14 studies with 723 T2DM patients and 473 healthy controls were finally included in the meta-analysis. The results showed that T2DM patients had significantly higher Cys C levels compared to healthy controls (SMD = 1.39, 95% CI: 0.92-1.86, p < 0.001). Publication bias was not detected based on the symmetrical shape of the funnel plot and the results of Egger's test (p = 0.452). Subgroup analyses suggested that variables of human race, age, gender, study sample size and disease duration have a relationship with Cys C level in T2DM patients. Conclusions: Overall, our study suggests that patients with T2DM have an elevated circulating Cys C level compared to healthy controls, and it is associated with race, age, gender, study sample size and disease duration. Further investigations are still needed to explore the causal relationship of aberrant Cys C concentrations in T2DM.

Parent-of-origin effects in the UK Biobank

“…The same SNP also shows maternal effects on HDL cholesterol and apolipoprotein A, both tightly related to T2D [25][26][27][28] . At 11p15.5, we found rs2237892, rs231362 and rs2334499 associated through different types of PofO effects with Cystatin C, another putative biomarker for T2D [29][30][31] . Finally, the T allele of rs2334499 seems to decrease multiple weight-and fat-related phenotypes when paternally inherited, and conversely increase them when maternally inherited.…”

The effect of beinaglutide on visceral fat and bodyweight in obese type 2 diabetic patients

“…The effects of the active forms of GLP-1 are mediated by a G protein-coupled receptor, GLP-1R, which is expressed in several sites, including enteric and vagal nerves, the stomach, pancreas, intestine, and various regions of the brain [29]. The physiological functions of GLP-1 include insulin secretion stimulation; glucagon secretion inhibition; protecting β-cells through endoplasmic reticulum stress reduction; reduction of food intake; stomach emptying reduction, thereby reducing the postprandial glucose peak; improvements in cardiomyocyte glucose utilisation, cardiac function, and cardiovascular protection [25,30,31]; and appetite suppression at the level of the hypothalamus and the promotion of weight loss [32][33][34]. Additionally, recent evidence suggests that GLP-1 RA may have a direct action (independent of central nervous system (CNS) actions) in the white adipose tissue inducing browning, enhancing lipolytic capacity and mitochondrial biogenesis [35].…”

Association between socioeconomic position and cystatin C in the Heinz Nixdorf Recall Study

“…In Shankar and Teppala this association has been found for women, but not for men in a cross-sectional study design 12 . A systematic review and meta-analysis by Ma et al demonstrated that type 2 diabetes mellitus patients had higher cystatin C compared to healthy controls 13 . In a meta-analysis by van der Laan et al cystatin C was associated with several cardiovascular risk factors and traits like LDL, HDL, BMI, diastolic blood pressure and smoking.…”