Vol 12, No 3 (2011): Practical Diabetology
Research paper
Published online: 2011-10-10
Cistatin C as an early marker for renal function loss in type 2 diabetic patients with concomitant albuminuria
Diabetologia Praktyczna 2011;12(3):103-112.
Abstract
BACKGROUND. Type 2 diabetes is the main cause of
the end-stage renal insufficiency needed renal
replacement therapy. Vascular damage turn leads to
diabetic nephropathy leads and progress from onset
of hyperglycemia. Albuminuria is first laboratory
indicator confirm the damage of the renal
glomerulus. Cystatin C is sensitive marker of
a developing renal dysfunction. Aim of the research:
what are the relations between concentration of
cystatin C in blood and albuminuria and HbA1c in
type 2 diabetes?
MATERIAL AND METODS. The research included 68 patients with type 2 diabetes and confirmed albuminuria. Based on the degree of metabolic control expressed by the percentage of HbA1c, the patients were divided into two groups: I group — 29 patients with type 2 diabetes with HbA1c ≥ 6.1% to £ 6.5%, with the average duration of diabetes of 5.3 years. II group — 39 patients with type 2 diabetes with HbA1c > 6.5% to £ 10.0%, with the average duration of diabetes of 7.2 years. K — the control group consisted of 21 patients with essential hypertension and albuminuria, not suffering from carbohydrates disorders. Concentration cystatin C in blood was assessed with the ELISA test, the percentage of HbA1c was measured immunoturbidimetric method. A Mann-Whitney test was used for the comparison between the values of the parameters in the research groups and the control group. Spearman’s rank correlation coefficient was used for measuring the relation between the axtent of albuminuria and the other parameters.
RESULTS. The average concentration of HbA1c in group II was 7.54% and was connected with significantly larger average glycaemia (p < 0.001) in comparison with group I with normal HbA1c concentration. The highest albumin excretion in urine and highest average concentration cystatin C in blood was in group II patients with type 2 diabetes with HbA1c > 6.5% to £ 10.0%. In group II patients with type 2 diabetes and abnormal metabolic control the average concentration of cystatin C was significantly higher than in the control group patients with essential hypertension. This difference however was not statistically significant. Nevertheless a positive correlation was found between the concentration of cystatin C in blood and the extent of albuminuria in research group I patients with type 2 diabetes with HbA1c < 6.5% (p = 0.005).
CONCLUSIONS. The positive correlation between the concentration of cystatin C and the extent of albuminuria, found in the research on patients with type 2 diabetes and normal percentage of HbA1c (p = 0.005) with shorts average duration of diabetes about of 5 years, confirms the sensitivity of this marker even at early stages of renal dysfunction.
(Diabet. Prakt. 2011; 12, 3: 103–112)
MATERIAL AND METODS. The research included 68 patients with type 2 diabetes and confirmed albuminuria. Based on the degree of metabolic control expressed by the percentage of HbA1c, the patients were divided into two groups: I group — 29 patients with type 2 diabetes with HbA1c ≥ 6.1% to £ 6.5%, with the average duration of diabetes of 5.3 years. II group — 39 patients with type 2 diabetes with HbA1c > 6.5% to £ 10.0%, with the average duration of diabetes of 7.2 years. K — the control group consisted of 21 patients with essential hypertension and albuminuria, not suffering from carbohydrates disorders. Concentration cystatin C in blood was assessed with the ELISA test, the percentage of HbA1c was measured immunoturbidimetric method. A Mann-Whitney test was used for the comparison between the values of the parameters in the research groups and the control group. Spearman’s rank correlation coefficient was used for measuring the relation between the axtent of albuminuria and the other parameters.
RESULTS. The average concentration of HbA1c in group II was 7.54% and was connected with significantly larger average glycaemia (p < 0.001) in comparison with group I with normal HbA1c concentration. The highest albumin excretion in urine and highest average concentration cystatin C in blood was in group II patients with type 2 diabetes with HbA1c > 6.5% to £ 10.0%. In group II patients with type 2 diabetes and abnormal metabolic control the average concentration of cystatin C was significantly higher than in the control group patients with essential hypertension. This difference however was not statistically significant. Nevertheless a positive correlation was found between the concentration of cystatin C in blood and the extent of albuminuria in research group I patients with type 2 diabetes with HbA1c < 6.5% (p = 0.005).
CONCLUSIONS. The positive correlation between the concentration of cystatin C and the extent of albuminuria, found in the research on patients with type 2 diabetes and normal percentage of HbA1c (p = 0.005) with shorts average duration of diabetes about of 5 years, confirms the sensitivity of this marker even at early stages of renal dysfunction.
(Diabet. Prakt. 2011; 12, 3: 103–112)
Keywords: type 2 diabeteshyperglycemiaalbuminuriadiabetes nephropathycystatine C