engleski

Cystatin C was superior to other tested markers in predicting renal function in type 2 diabetes

Aims: The aim was to determine main predictors of renal function in type 2 diabetes (DM2) among inflammatory and other tested markers of endothelial dysfunction. Methods: Adiponectin (ApN), C-reactive protein (CRP), fibrinogen (FIB), homocysteine (HCY), interleukin-6 (IL-6), cystatin C (Cys C), creatinine clearance (CrCl), albumin excretion rate (AER), C-peptide, waist/hip ratio (WHR), fasting (fPG) and postprandial plasma glucose (ppPG), glycated haemoglobin (A1c), insulin resistance index (IIR), liver function tests, lipids, ferritin, uric acid (UA), and leucocytes (WBC) were determined in patients with DM2 assigned to AER (<30, 30-300, >300) and CrCl (M:≤1.17 ; >1.17 ; F:≤0.83, >0.83) subgroups. DM2 patients were divided according to oral hypoglycaemic therapy (DM2-OHD) or insulin (DM2-IN). AER predictors were determined by linear regression analysis. Differences between AER and CrCl categories were tested by analysis of variance. Results: Significant differences were determined in Cys C among AER (DF=2, F=37.96, p<0.001) ( 2.05±0.29 vs. 2.04±0.26 vs. 2.20±0.28) and CrCl subgroups (DF=2, F=31.65, p<0.001) (2.09±0.39 vs. 2.07±0.27). Tukey post hoc test showed significant differences in Cys C between patients with AER <30 and 30-300, and <30 and >300. In DM2 AER was best predicted by Model1 (R2 = 0.539): Cys C, triglycerides (Tg) and C-peptide, and Model2 (R2 = 0.548): fPG, Cys C and aspartate transaminase (AST). In all models selected predictors were statistically significant at the 5% level. Cys C correlated significantly with WHR, CRP, HCY, FIB, AER, UA, IL-6 and CrCl. T-test showed no significant differences (p<0.01) in ApN, CRP, FIB, HCY, IL-6 and Cys C between DM2-OHD and DM2-IN. Conclusion: Significant differences in Cys C were found in DM2 according to AER and CrCl. The study pointed to Cys C as the main predictor of nephropathy in type 2 diabetes.

Cystatin C; diabetic nephropathy; inflammation

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