Diagnostic value of cystatin C for the early diagnosis of diabetic nephropathy
V. N. Vasilkova,
I. Yu. Pchelin,
E. P. Naumenka,
Ya. A. Borovets,
Yu. I. Yarets,
L. E. Korotaeva,
I. A. Vasukhina,
T. V. Mokhort https://doi.org/10.51523/2708-6011.2021-18-2-12
Abstract
Objective: to assess the clinical significance of cystatin C in the early diagnosis of diabetic nephropathy.
Materials and methods. We examined 449 patients with type 1 and type 2 diabetes mellitusolder than 25 years. The laboratory examination of the patients included the measurement of cystatin, creatinine in the blood serum, GFR calculation according to the CKD-EPI equation, and the determination of albuminuria levels.
Results. The role of cystatin C as a reliable marker of diabetic nephropathy has been demonstrated: the level of cystatin C ≥ 0.72 mg/L with sensitivity of 90.8 %, specificity of 88.9 %, was associated with a decline of renal function in the diabetic patients (ROC AUC = 0.951).
Conclusion. The determination of the level of cystatin C, alone or in conjunction with creatinine, will help to more accurately diagnose GFR and assess the risk of mortality and renal complications in patients with diabetes mellitus.
Supporting agencies: This study was supported by the Belarusian Foundation for Basic Research (BFBR) (research project No. М17РМ-113) and Russian Foundation for Basic Research (RFBR) (research project No.17-54-04080).
About the Authors
V. N. Vasilkova
Gomel State Medical University
Belarus
Belarus
Volha N. Vasilkova, PhD (Med), Associate Professor at the Department of Internal Diseases No. 1 with the course of Endocrinology
Gomel
I. Yu. Pchelin
Saint Petersburg State University
Russian Federation
Russian Federation
Ivan Yu. Pchelin, PhD (Med), Associate Professor performing clinical work at the Department of Faculty Therapy
Saint Petersburg
E. P. Naumenka
Republican Scientific and Practical Center for Radiation Medicine and Human Ecology
Belarus
Belarus
Elena P. Naumenka, physician of functional diagnostics
Gomel
Ya. A. Borovets
Gomel State Medical University
Belarus
Belarus
Yana A. Borovets, Assistant Lecturer at the Department of Internal Diseases No. 1 with the course of Endocrinology
Gomel
Yu. I. Yarets
Republican Scientific and Practical Center for Radiation Medicine and Human Ecology
Belarus
Belarus
Yulia I. Yarets, PhD (Med), Associate Professor, Head of the Clinical Diagnostic Laboratory
Gomel
L. E. Korotaeva
Republican Scientific and Practical Center for Radiation Medicine and Human Ecology
Belarus
Belarus
Ludmila E. Korotaeva, laboratory physician at the Cell Technologies Laboratory
Gomel
I. A. Vasukhina
Republican Scientific and Practical Center for Radiation Medicine and Human Ecology
Belarus
Belarus
Irina A. Vasukhina, endocrinologist
Gomel
T. V. Mokhort
Belarusian State Medical University
Belarus
Belarus
Tatsiana V. Mokhort, DMedSc, Professor, Head of the Department of Endocrinology
Minsk
References
1. Żyłka A, Dumnicka P, Kuśnierz-Cabala B, Gala-Błądzińska A, Ceranowicz P, Kucharz J, Ząbek-Adamska A, Maziarz B, Drożdż R, Kuźniewski M. Markers of Glomerular and Tubular Damage in the Early Stage of Kidney Disease in Type 2 Diabetic Patients. Mediators Inflamm. 2018;9:7659243. https://doi.org/10.1155/2018/7659243
2. Satirapoj B, Pooluea P, Nata N, Supasyndh O. Urinary biomarkers of tubular injury to predict renal progression and end stage renal disease in type 2 diabetes mellitus with advanced nephropathy: A prospective cohort study. J Diabetes Complications. 2019 Sep;33(9):675–681. https://doi.org/10.1016/j.jdiacomp.2019.05.013
3. Hill NR, Fatoba ST, Oke JL, Hirst JA, et al. Global prevalence of chronic kidney disease – a systematic review and meta-analysis. PLoS One. 2016;11(7):e0158765. https://doi.org/10.5061/dryad.3s7rd
4. Gansevoort RT, Correa-RotterR, et al. Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. The Lancet. 2013;382(9889):339–352. https://doi.org/10.1016/S0140-6736(13)60595-4
5. Subbiah AK, Chhabra YK, Mahajan S. Cardiovascular disease in patients with chronic kidney disease: a neglected subgroup. Heart Asia. 2016;8(2):56–61. https://doi.org/10.1136/heartasia-2016-010809
6. Siddiqi Z, Karoli R, Kaul A, Fatima J, Varshney S, Beg MS. Evaluation of neutrophil gelatinase-associated lipocalin and cystatin C as early markers of diabetic nephropathy. Ann Afr Med. 2017;16(3):101–106. https://doi.org/10.4103/aam.aam_12_17
7. Rotbain Curovic V, Hansen TW, Eickhoff MK, von Scholten BJ, Reinhard H, Jacobsen PK, Persson F, Parving HH, Rossing P. Urinary tubular biomarkers as predictors of kidney function decline, cardiovascular events and mortality in microalbuminuric type 2 diabetic patients. Acta Diabetol. 2018;55(11):1143–1150. https://doi.org/10.1007/s00592-018-1205-0
8. Vijay S, Hamide A, Senthilkumar GP, Mehalingam V. Utility of urinary biomarkers as a diagnostic tool for early diabetic nephropathy in patients with type 2 diabetes mellitus. Diabetes Metab Syndr. 2018 Sep;12(5):649-652. https://doi.org/10.1016/j.dsx.2018.04.017
9. Willems D, Wolff F, Mekhali F, et al. Cystatin C for early detection of renal impairment in diabetes. Clin Biochem. 2009;2(1-2):108-110. https://doi.org/10.1016/j.clinbiochem.2008.10.002
10. Kravaritou M, Thanopoulou A, Karamanos B, et al. Evidence that even “normal” albuminuria may denote incipient GFR reduction in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2009;85(3):317–321. https://doi.org/10.1016/j.diabres.2009.06.019
11. Elsayed MS, El Badawy A, Ahmed A, Omar R, Mohamed A. Serum cystatin C as an indicator for early detection of diabetic nephropathy in type 2 diabetes mellitus. Diabetes Metab Syndr. 2019;13(1):374–381. https://doi.org/10.1016/j.dsx.2018.08.017
12. Arceo ES, Dizon GA, Tiongco REG. Serum cystatin C as an early marker of nephropathy among type 2 diabetics: A meta-analysis. Diabetes Metab Syndr. 2019;13(6):3093– 3097. https://doi.org/10.1016/j.dsx.2019.11.007
13. Oddoze C, Morange S, Portugal H, Berland Y, Dussol B. Cystatin C is not more sensitive than creatinine for detecting early renal impairment in patients with diabetes. Am J Kidney Dis. 2001;38(2):310–316. https://doi.org/10.1053/ajkd.2001.26096
14. nostic accuracy of various glomerular filtration rates estimating equations in patients with chronic kidney disease and diabetes. Chin Med J (Engl). 2010 Mar 20;123(6):745–751.
15. Pucci L, Triscornia S, Lucchesi D, et al. Cystatin C and estimates of renal function: searching for a better measure of kidney function in diabetic patients. Clin Chem. 2007 Mar;53(3):480–488. https://doi.org/10.1373/clinchem.2006.076042
Review
For citations:
Vasilkova V.N., Pchelin I.Yu., Naumenka E.P., Borovets Ya.A., Yarets Yu.I., Korotaeva L.E., Vasukhina I.A., Mokhort T.V. Diagnostic value of cystatin C for the early diagnosis of diabetic nephropathy. Health and Ecology Issues. 2021;18(2):79-85. (In Russ.) https://doi.org/10.51523/2708-6011.2021-18-2-12
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