Role of Cystatin C in early detection of renal impairment in Pre-diabetics
Nahla Nader Adly;
Abstract
SUMMARY
P
rediabetes, based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Observational evidence showed associations of prediabetes with early forms of nephropathy, defined based on methods such as urinary albumin excretion rate and estimated glomerular filtration rate (eGFR). Thus, there needs to be increased awareness on the part of the medical community and public about the insidious consequences of prediabetes.
Cystatin C, a novel marker of kidney function has been shown to predict renal function decline earlier than serum creatinine, the traditional marker of kidney function. Evidences have shown that elevated levels of cystatin C are associated with prediabetes in particular, in the early stages of chronic kidney disease (CKD).
The aim is to study the role of Cystatin C in early detection of renal affection in pre-diabetic patients.
Our study was conducted on 80 subjects selected from relatives of diabetic patients, persons at high risk for diabetes mellitus and also healthy volunteers their age ranges from 40 to 60 yrs from Ain Shams University hospitals from August 2013 to February 2014. Informed consent was obtained from all subjects included in the study.
All participants were subjected to full medical history taking, General clinical examination and Laboratory investigations including (oral glucose tolerance test, BUN, serum creatinine, protein/creatinine ratio in urine, HbA1C%, serum cystatin C level). In addition, Estimated GFR was calculated based on serum cystatin C levels using the formula (eGFR=127.7 × serum cystatin C−1.17× age − 0.13× 1.06 [if black] ×0.91 [if female]). Subjects with Patients known to be diabetic or with renal disease, systemic or inflammatory diseases that could affect the kidneys or on nephrotoxic drugs were excluded from our study.
We classified our subjectss according to oral glucose tolerance test into:
Group I: 40 subjects diagnosed to be pre-diabetic (impaired fasting glucose 100-125 mg/dl, impaired glucose tolerance 140- 199 mg/dl or both) by using oral glucose tolerance test.
Group II: 40 healthy volunteers.
Our results revealed the following:
On comparing Group Ι (prediabetics) with Group ΙΙ (healthy volunteers), we found that, there was highly significant difference between both groups in FBS (p-value < 0.001), HbA1C% (p-value < 0.001), serum cystatin C level (p-value < 0.001) and Egfr (p-value < 0.001), and there was significant difference between both groups in BMI (p-value < 0.05), but there was no significant difference between both groups in age (p-value> 0.05), BUN (p-value > 0.05), Creat (p-value > 0.05), protein/creatinine ratio (p-value > 0.05).
Regarding the correlation between serum cystatin C and other parameters in group I there was a highly significant positive correlation between serum cystatin C and FPG (r=0.833) and HbA1c (r=0.661) with (p-value < 0.001) a significant positive correlation between serum cystatin C level and 1hPP(r=0.468) and 2hPP (r=0.483) with (p-value< 0.05) and there was a highly significant negative correlation between serum cystatin C and eGFR (r= -0.966) with (p-value < 0.001) ,While in group II (healthy volunteers) there was no statistical significant correlation between serum cystatin C level and FPG (r=0.152), 2hPP (r=0.121), HbA1c (r= -0.073), with (p-value > 0.05) but there was a highly significant negative correlation between serum cystatin C level and eGFR (r=-0.933) with
(p-value < 0.001), and there was no statistical significant correlation between serum cystatin C level and gender in both groups with (p-value=0.074), also there was a significant negative correlation between eGFR and1hr PPG and 2hrPPG and a highly significant negative correlation between eGFR and FBG and HbA1C% in both groups.
P
rediabetes, based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Observational evidence showed associations of prediabetes with early forms of nephropathy, defined based on methods such as urinary albumin excretion rate and estimated glomerular filtration rate (eGFR). Thus, there needs to be increased awareness on the part of the medical community and public about the insidious consequences of prediabetes.
Cystatin C, a novel marker of kidney function has been shown to predict renal function decline earlier than serum creatinine, the traditional marker of kidney function. Evidences have shown that elevated levels of cystatin C are associated with prediabetes in particular, in the early stages of chronic kidney disease (CKD).
The aim is to study the role of Cystatin C in early detection of renal affection in pre-diabetic patients.
Our study was conducted on 80 subjects selected from relatives of diabetic patients, persons at high risk for diabetes mellitus and also healthy volunteers their age ranges from 40 to 60 yrs from Ain Shams University hospitals from August 2013 to February 2014. Informed consent was obtained from all subjects included in the study.
All participants were subjected to full medical history taking, General clinical examination and Laboratory investigations including (oral glucose tolerance test, BUN, serum creatinine, protein/creatinine ratio in urine, HbA1C%, serum cystatin C level). In addition, Estimated GFR was calculated based on serum cystatin C levels using the formula (eGFR=127.7 × serum cystatin C−1.17× age − 0.13× 1.06 [if black] ×0.91 [if female]). Subjects with Patients known to be diabetic or with renal disease, systemic or inflammatory diseases that could affect the kidneys or on nephrotoxic drugs were excluded from our study.
We classified our subjectss according to oral glucose tolerance test into:
Group I: 40 subjects diagnosed to be pre-diabetic (impaired fasting glucose 100-125 mg/dl, impaired glucose tolerance 140- 199 mg/dl or both) by using oral glucose tolerance test.
Group II: 40 healthy volunteers.
Our results revealed the following:
On comparing Group Ι (prediabetics) with Group ΙΙ (healthy volunteers), we found that, there was highly significant difference between both groups in FBS (p-value < 0.001), HbA1C% (p-value < 0.001), serum cystatin C level (p-value < 0.001) and Egfr (p-value < 0.001), and there was significant difference between both groups in BMI (p-value < 0.05), but there was no significant difference between both groups in age (p-value> 0.05), BUN (p-value > 0.05), Creat (p-value > 0.05), protein/creatinine ratio (p-value > 0.05).
Regarding the correlation between serum cystatin C and other parameters in group I there was a highly significant positive correlation between serum cystatin C and FPG (r=0.833) and HbA1c (r=0.661) with (p-value < 0.001) a significant positive correlation between serum cystatin C level and 1hPP(r=0.468) and 2hPP (r=0.483) with (p-value< 0.05) and there was a highly significant negative correlation between serum cystatin C and eGFR (r= -0.966) with (p-value < 0.001) ,While in group II (healthy volunteers) there was no statistical significant correlation between serum cystatin C level and FPG (r=0.152), 2hPP (r=0.121), HbA1c (r= -0.073), with (p-value > 0.05) but there was a highly significant negative correlation between serum cystatin C level and eGFR (r=-0.933) with
(p-value < 0.001), and there was no statistical significant correlation between serum cystatin C level and gender in both groups with (p-value=0.074), also there was a significant negative correlation between eGFR and1hr PPG and 2hrPPG and a highly significant negative correlation between eGFR and FBG and HbA1C% in both groups.
Other data
| Title | Role of Cystatin C in early detection of renal impairment in Pre-diabetics | Other Titles | دور مركب السيستاتن (ج) في الأكتشاف المبكر لقصور وظائف الكلى في مرضى ما قبل السكري | Authors | Nahla Nader Adly | Issue Date | 2014 |
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