Relationship between High Serum Cystatin C Levels and the Risk of Gestational Diabetes Mellitus

Abstract

AimsSerum cystatin C (CysC) has recently been shown to be associated with the incidence of type 2 diabetes mellitus (T2DM) and progression to the pre-diabetic state. The aim of this study was to explore the relationship between serum CysC and the risk of gestational diabetes mellitus (GDM) in Chinese pregnant women.MethodsThis cross-sectional study consisted of 400 pregnant women including111 with GDM and 289 with normal glucose tolerance at 24–28 weeks of gestation. The subjects were further divided into four groups according to the CysC quartiles, and their clinical characteristics were compared. The serum CysC concentration was measured using immunoturbidimetry and the degree of insulin resistance was assessed by the homeostasis model assessment of insulin resistance (HOMA-IR).ResultsSerum CysC levels were significantly higher in pregnant women with GDM than in the healthy pregnant women[1.0(0.8–1.8) vs 0.7(0.6–1.0), P<0.01). The Spearman’s correlation analysis showed that serum CysC was positively associated with HOMA-IR(r = 0.118, P<0.05) and the occurrence of GDM(r = 0.348, P<0.01). The pregnant women were divided into quartiles according to their serum CysC concentrations. Compared to the first quartile, pregnant women in Q2 (OR, 2.441; P = 0.025), Q3 (OR, 3.383; P = 0.001) and Q4 (OR, 5.516; P<0.001) had higher risk of GDM after adjusted for age, BMI, HbA1c and HOMA-IR. Further, with a rise in the serum CysC, there was an increasing trend in the HOMA-IR levels (P<0.05). A binary logistic regression analysis after adjusting for other confounding variables revealed a significant and independent association between serum CysC and GDM [OR = 14.269; 95% confidence interval, 4.977–40.908, P<0.01].The receiver operating characteristic curve analysis revealed that the optimal cutoff point for serum CysC to indicate GDM was 0.95mg/L.ConclusionsSerum CysC is significantly and independently associated with insulin resistance and GDM. It may be a helpful biomarker to identify the risk of GDM in Chinese pregnant women.

Clinical Role, Diagnostic and Prognostic Value of Human Cystatin C Through the Body

“…Several studies have also found the Cystatin C level also to be correlated with different components of the metabolic syndrome 86 . Previous studies have demonstrated that serum Cystatin C is a strong marker for lower limb ischemia, diabetic retinopathy and diabetic peripheral neuropathy in Chinese patients with type 2 diabetes mellitus 86 . It is considered as a useful index in the screening of diabetic micro-and macro-vascular complications 86 .…”

“…Cystatin C is considered a more sensitive measure for estimating the glomerular filtration rate than serum creatinine, it is superior to creatinine as a marker of kidney function, risk factor of cardiovascular disease and diabetes retinopathy as well 86 . Cystatin C has recently been shown to be associated with the incidence of type 2 diabetes mellitus and the progression to the pre-diabetic state 86 . Several studies have also found the Cystatin C level also to be correlated with different components of the metabolic syndrome 86 .…”

“…Cystatin C has recently been shown to be associated with the incidence of type 2 diabetes mellitus and the progression to the pre-diabetic state 86 . Several studies have also found the Cystatin C level also to be correlated with different components of the metabolic syndrome 86 . Previous studies have demonstrated that serum Cystatin C is a strong marker for lower limb ischemia, diabetic retinopathy and diabetic peripheral neuropathy in Chinese patients with type 2 diabetes mellitus 86 .…”

“…Yousefzadeh et al reported that Cystatin C could be a reliable, useful and promising marker of gestational diabetes mellitus 86 .…”

Integrated miRNA-mRNA Expression Profile Analysis Reveals a Role of miR-146a-3p/TRAF6 in Plasma from Gestational Diabetes Mellitus Patients

“…Serum CysC is significantly and independently associated with insulin resistance, which is helpful in identifying the risk of GDM in Chinese pregnant women [9]. In addition, the combined detection of plasma microRNA-16-5p, -17-5p and − 20a-5p is expected to provide early diagnosis for pregnant women with GDM [10].…”