Early prediction of nephropathy and cardiovascular diseases in Indian patients with type 2 diabetes mellitus

Abstract

Background: It is well established that patients with type 2 diabetes mellitus are at increased risk for chronic kidney and cardiovascular diseases. Diagnosis of diabetic nephropathy and cardiovascular diseases at an early stage in patients with type 2 diabetes mellitus is difficult. Therefore, biomarker for estimation of renal function was chosen. Aims and Objectives: To evaluate serum cystatin C and its correlation with biochemical, clinical, and anthropometric parameters in patients with type 2 diabetes and healthy controls. Materials and Methods: The levels of serum cystatin C were evaluated in 100 subjects (50 with type 2 diabetes and 50 controls) of age group 40-70 years and were measured using particle-enhanced immunonephelometry. Results: The levels of serum cystatin C were found to be significantly increased in patients with diabetes mellitus (0.97 ± 0.19 mg/L; P < 0.01) than healthy controls (0.84 ± 0.1 mg/L). In this study, it was found that few diabetes patients with normoalbuminuria with elevated levels of serum cystatin C and cystatin C-based estimated glomerular filtration rate (eGFR). The levels of serum cystatin C correlated positively with eGFR, serum creatinine, and systolic blood pressure and showed negative correlation with estimated creatinine clearance and no association with body mass index, waist-to-hip ratio, and diastolic blood pressure. Conclusion: Measurement of the levels of serum cystatin C is a useful, practical, noninvasive technique for the evaluation of renal involvement and might be related with a risk for cardiovascular events in patients without nephropathy in the course of diabetes, especially in patients with normoalbuminuria.

Cystatin C, Vitamin D and Thyroid Function Test Profile in Chronic Kidney Disease Patients

“…Studies have demonstrated that serum cystatin C is a sensitive biomarker for detecting changes in GFR and identifying preclinical renal disease, particularly in diabetic patients with a normal serum creatinine concentration [ 9 ]. Furthermore, cystatin C is a better discriminator between type 2 diabetic patients with normoalbuminuria or microalbuminuria and its quantification is useful in the early identification of diabetic nephropathy allowing for the appropriate intervention and management [ 10 ].…”

Clinical Significance of Cystatin C-Based Estimates of Renal Function in Type 2 Diabetic Patients: Review

“…One recent study Rao et al indicated that levels of cystatin C are related to subclinical renal damage and can be an earlier measurable marker of renal involvement in type 2 diabetes even before the onset of albuminuria [34]. Another study by Surendar et al found that cystatin C levels were highest in type 2 diabetic patients without microalbuminuria, indicating that cystatin C can detect early renal damage even before the development of albuminuria.…”

“…In the same context, a recent study, including 42 patients with type 2 diabetes, showed that only cystatin C level was associated with increased risk of CVD, which indicated that cystatin C may be a valuable and useful marker for predicting CVD in type 2 diabetic patients [68]. Another study also demonstrated that measurement of the levels of serum cystatin C is a useful, practical, noninvasive technique for the evaluation of renal involvement and might be related with a risk for cardiovascular events in patients without nephropathy in the course of diabetes, especially in patients with normoalbuminuria [34].…”