Abstract
ObjectiveCystatin C is growing to be an ideal indicator for renal function and cardiovascular events. The aim of this study was to investigate the relationship between serum cystatin C levels and peripheral arterial disease and to explore its diagnostic value for lower limb ischemia (LLI) in type 2 diabetic population.MethodsA total of 1609 T2DM patients were included in this cross-sectional study. Their clinical and biochemical characteristics, ankle-brachial index (ABI), carotid and lower extremity arterial ultrasound were detected. LLI was defined by ABI <0.9 and lower extremity arterial stenosis >50% by ultrasound examination. Patients were divided to two groups: with LLI and without. The risk factors of LLI were explored by binary logistic regression analysis.ResultsThe serum concentrations of cystatin C were 1.53±0.60 and 1.08±0.30 mg/L in patients with and without LLI, respectively. Binary logistic regression analysis showed that the significant risk factors were cystatin C (P = 0.007, OR = 5.081), the presence of hypertension (P = 0.011, OR = 3.527), age (P<0.001, OR = 1.181), GA (P = 0.002, OR = 1.089) and diabetes duration (P = 0.008, OR = 1.074). The prevalence of coronary artery disease, cerebral infarction and LLI increased with cystatin C (P<0.01), and the prevalence of LLI in patients with cystatin C >1.2 mg/L was much higher than other three quartile groups. Receiver operating characteristic curve analysis revealed the cut point of cystatin C for LLI was 1.2 mg/L. The risk of LLI dramatically increased in patients with cystatin C >1.2 mg/L (OR = 21.793, 95% confidence interval 10.046−47.280, P<0.001). After adjusting for sex, age, duration, HbA1c, GA and hypertension, its OR still remained 3.395 (95% confidence interval 1.335–8.634).ConclusionsThere was a strong and independent association between cystatin C and limb arterial disease in diabetic population, and cystatin C >1.2 mg/L indicated a great increased risk of LLI.
Highlights
Lower limb ischemia (LLI) caused by peripheral arterial disease (PAD) is the major risk factor of foot ulceration and amputation which severely impairs the patients’ life quality
The purpose of this study is to explore the association between cystatin C and PAD, and to clarify its clinical value for LLI in Chinese patients who suffered from type 2 diabetes mellitus (T2DM)
There was no difference in Body mass index (BMI), Fasting plasma glucose (FPG), postprandial blood glucose (PPG), PLT, White blood cell (WBC), uric acid (UA), TG and c-glutamyl transpeptidase (c-GT) between two groups
Summary
Lower limb ischemia (LLI) caused by peripheral arterial disease (PAD) is the major risk factor of foot ulceration and amputation which severely impairs the patients’ life quality. [1] it is vital for diabetic patients to recognize LLI and to control the risk factors of PAD as early as possible. It is well known that elder age, diabetes duration, cigarette smoking, poor glucose control, hypertension and hyperlipidemia are the traditional risk factors of arteriosclerosis for diabetic patients. [12] there is limited data about the association between serum cystatin C levels and LLI in type 2 diabetic patients. The purpose of this study is to explore the association between cystatin C and PAD, and to clarify its clinical value for LLI in Chinese patients who suffered from type 2 diabetes mellitus (T2DM)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
