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

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 estimat ing 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 don e 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 as sociations with Cystatin C were age (β = 0.009, P < 0.0001), hemoglobin (β = -0.038, P = 0.0006), serum creatinine (β = 0.719, β < 0.0001), uric acid (β = 0.048, P = 0.0004), log hsCRP (β = 0.035, P = 0.0021) and homocysteine (β = 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. (KOREAN DIABETES J 32:488-497, 2008)