Korean Diabetes J.  2008 Dec;32(6):488-497. 10.4093/kdj.2008.32.6.488.

Cystatin C is a Valuable Marker for Predicting Future Cardiovascular Diseases in Type 2 Diabetic Patients

• Lee SH
• Lee KW
• Kim ES
• Park YR
• Kim HS
• Park SA
• Kang MJ
• Ahn YB
• Yoon KH
• Cha BY
• Son HY
• Kwon HS

• KMID: 2222456
• DOI: http://doi.org/10.4093/kdj.2008.32.6.488

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 (beta = 0.009, P < 0.0001), hemoglobin (beta = -0.038, P = 0.0006), serum creatinine (beta = 0.719, beta < 0.0001), uric acid (beta = 0.048, P = 0.0004), log hsCRP (beta = 0.035, P = 0.0021) and homocysteine (beta = 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.

Keyword

Biomarkers; Cardiovascular disease; Cystatin C; Type 2 diabetes

MeSH Terms

Biomarkers
Cardiovascular Diseases
Carotid Intima-Media Thickness
Coronary Disease
Creatinine
Cystatin C
Fibrinogen
Hemoglobins
Homocysteine
Humans
Lipoprotein(a)
Risk Factors
Stroke
Uric Acid
Creatinine
Cystatin C
Fibrinogen
Hemoglobins
Homocysteine
Lipoprotein(a)
Uric Acid

Figure

• 

  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.

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