Abstract
Background and objectives: This study aimed to assess the clinical significance of serum cystatin C in the early diagnosis of renal injury and its association with dyslipidemia in young T1D patients. Materials and Methods: A total of 779 subjects were evaluated for kidney function by estimating glomerular filtration rate (eGFR) based on serum creatinine (eGFRcreat) and cystatin C (eGFRcys). Results: The median age of study subjects was 16.2 years (2.1;26.4), diabetes duration—5.3 years (0.51;24.0). The median of HbA1c was 8% (5.2;19.9) (64 mmol/mol (33.3;194)); 24.2% of participants had HbA1c < 7% (53 mmol/mol). Elevated albumin excretion rate was found in 13.5% of subjects. The median of cystatin C was 0.8 mg/L (0.33;1.71), the median of creatinine—63 µmol/L (6;126). The median of eGFRcys was lower than eGFRcreat (92 mL/min/1.73 m2 vs. 101 mL/min/1.73 m2, p < 0.001). A total of 30.2% of all patients were classified as having worse kidney function when using cystatin C vs. creatinine for eGFR calculation. Linear correlations were found between cystatin C and HbA1c, r = −0.088, p < 0.05, as well as cystatin C and HDL, r = −0.097, p < 0.01. Conclusions: This study showed that cystatin C might be used as an additional biomarker of early kidney injury in young patients with T1D.
Highlights
Diabetic kidney disease is defined as renal dysfunction or structural abnormalities lasting for 3 or more months and highly affecting the patient’s quality of life [1]
After grouping patients according to the equivalency of Estimated glomerular filtration rate (eGFR) levels calculated by creatinine and cystatin C, we found that 30.2% of patients had worse eGFR levels calculated using cystatin C (Group 2 when eGFRcreat level < eGFRcys level), 61.1% had the same eGFR level using both biomarkers (Group 1) and 8.7% were classified as Group 3
type 1 diabetes (T1D) patients who may be suffering from early kidney damage, as one-third of the whole cohort was classified with worse eGFR levels when using cystatin C vs. creatinine
Summary
Diabetic kidney disease is defined as renal dysfunction or structural abnormalities lasting for 3 or more months and highly affecting the patient’s quality of life [1]. Hyperfiltration, and hyperperfusion, diabetic kidney damage progresses to end-stage renal disease, which is one of the leading causes of morbidity and mortality in young type 1 diabetic patients [2]. Recent data suggest the benefits of GFR calculated with serum cystatin C for evaluation of early risk for end-stage renal disease [3]. Cystatin C is a low-molecular-weight protein (Mw 13,343 Da), an inhibitor of endogenous cysteine protease [4]. It is produced in all tissues and found in all biological fluids
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