Please use this identifier to cite or link to this item:
|Title||Cystatin C and Other Markers of Nephropathy among Type 2 Diabetic Patients in Gaza Strip|
Background: Nephropathy is a significant cause of morbidity and mortality in patients with diabetes mellitus (DM). The condition is characterized by persistent albuminuria and may be decline in the glomerular filtration rate (GFR). Serum cystatin C has been proposed as a simple, accurate, and rapid endogenous marker of GFR. Aim of the study: To assess serum levels of cystatin C and some biochemical parameters among type 2 diabetes mellitus (T2DM) patients in Gaza Strip and whether these levels vary with stages of diabetic nephropathy (DNP). Methods: In this study, 95 patients and 95 controls were enrolled. Body mass index (BMI) and blood pressure were measured after conducting face to face interview for each participant. Morning fasting blood and urine samples were obtained for measurement of serum cystatin C, creatinine, urea, glucose, lipid profile, and urine albumin and creatinine. The albumin to creatinine ratio (ACR) was calculated. Serum cystatin C and urine albumin were measured by particle enhanced immunoturbidimetric assay. Serum and urinary creatinine, serum urea, glucose and lipid profile were measured using a specific enzymatic assay. The patients were divided into those with normo-, micro-, and macroalbuminuria. Results: About 51.6 % of diabetic patients had at least one diabetes complications. Frequencies of diabetes complications were increased with increase the duration of diabetes. Diabetes was found to be associated with family history and BMI (all P<0.05). About half of patients were diabetics since 5 years or less. Serum cystatin C levels were non-significantly changed in diabetic patients compared to controls (P>0.05). Serum urea and creatinine were lower in diabetics (all P<0.05). Cholesterol, triglycerides and low-density lipoprotein (LDL) were significantly higher in diabetics than controls (all P<0.05). In contrast, high-density lipoprotein (HDL) was significantly lower in diabetics (P<0.05). Diabetic patients showed higher levels of ACR (P<0.05). In contrast, urine creatinine level was lower in patients (P<0.05). The results of the study showed that 28.4% of the diabetic patients had microalbuminuria and 16.8% had macroalbuminuria. The mean levels of serum cystatin C in macroalbuminuria were significantly higher than those in normoalbuminuria or microalbuminuria (all P<0.05). The mean levels of serum urea in microalbuminuria and macroalbuminuria were significantly higher than those in normoalbuminuria (all P<0.05). However, the mean levels of serum creatinine in macroalbuminuria were significantly higher than those in normoalbuminuria or microalbuminuria (all P<0.05). The mean levels of ACR in macroalbuminuria were significantly higher than those in normoalbuminuria or microalbuminuria (all P<0.05). In addition, the mean levels of ACR in microalbuminuria were significantly higher than in normoalbuminuria (P<0.05). For diabetic patients there were positive significant correlation between serum cystatin C and age (r=0.440, P=0.000), duration (r=0.372, P=0.042), serum urea (r=0.873, P=0.000), serum creatinine (r=0.892, P=0.000), cholesterol (r=0.283, P=0.005), LDL (r=0.416, P=0.000) and urinary albumin (r=0.579, P=0.000), In contrast, cystatin C was negatively correlated with HDL (r=-0.645, P=0.000) and urinary creatinine (r=-0.656, P=0.000). Receiver operating characteristic (ROC) plots demonstrated that with a cutoff value of 30 mg/g, the area under the curve (AUC) was 0.719 for cystatin C and 0.624 for creatinine. With a cutoff value of 300 mg/g, the AUC was 0.907 for cystatin C and 0.882 for creatinine. Conclusion: The results of this study suggest that cystatin C measurement in serum is a useful, practical tool for the evaluation of renal involvement in the course of diabetes, especially in patients with DNP.
|Publisher||الجامعة الإسلامية - غزة|
|Files in this item|