Endocrine Abstracts

Background: Diabetic nephropathy (DN) is a serious complication of diabetes associated with increased risk of mortality, cardiovascular and renal outcomes. Diagnostic markers to detect DN at early stage are important as early intervention can slow loss of kidney function and improve patient outcomes. The aim of our study was to evaluate the role of serum cystatin C (CysC) for early detection of kidney damages in patients with type 2 diabetes mellitus (DT2).

Materials and methods: The renal function of the diabetic patients was evaluated using the albumin-creatinine ratio (ACR) and Kidney Disease Outcome Quality Initiative-Kidney Disease Improving Global Outcomes (K/DOQI-KDIGO) classification. Serum CysC and HbA1c were also measured in 84 diabetic and 36 healthy subjects.

Results: Serum CysC was significantly higher (1.3±0.9 mg/l) in diabetic patients with eGFR <60 ml/min than control subjects (0.8±0.2 mg/l), P<0.05. A significant correlation between CysC and eGFR (r=−0.26, P<0.05) was observed. CysC levels significantly increased with increasing CKD stage 1 to 3 and from normo- to microalbuminuria and showed a positive correlation with ACR (r=0.32, P=0.004). In a comparison of renal function markers in type 2 diabetic patients according to serum CysC level, all markers including ACR, serum creatinine, and eGFR showed significant differences between patients with CysC level <1.1 mg/l and those with CysC ≥1.1 mg/l.

Conclusion: According to our results, serum CysC is a useful marker for screening of DN in patients with DT2 because it reflects both a decrease in GFR and elevated ACR.