Endocrine Abstracts

Background: There are several markers of renal function such as estimated glomerular filtration rate (GFR) calculated by serum creatinine and cystatin C and urinary albumin-creatinine excretion ratio (ACR). Recently, a few studies showed relationships between markers of renal function and carotid arterty intima-media thickness (IMT), but the results were inconsistent. The aim of this study is to compare serum cystatin C as risk factors for atherosclerosis in Korean type 2 diabetic patients.

Methods: This study was performed in 450 type 2 diabetic patients, who were evaluated by serum cystatin C, urinary ACR (both divided into tertiles) and carotid artery IMT. Estimated GFR was calculated using the modification of diet in renal disease (MDRD) equation. The carotid artery IMT was assessed by B-mode ultrasonography.

Results: There were no differences in the proportion of gender, obesity, smoking status and dyslipidemia according to serum cystatin C tertiles. Higher level of serum cystatin C was associated with older age, longer duration of diabetes, lower HDL-cholesterol level and increased carotid artery mean IMT (P for trend <0.05, respectively). In multivariate analyses adjusted for traditional atherosclerotic risk factors, carotid artery mean IMT was strongly associated with urinary ACR and serum cystatin C (P for trend 0.025 and 0.032, respectively), but not with estimated GFR (P=0.954).

Conclusion: The level of serum cystatin C beyond traditional risk factors was related with carotid atherosclerotic burden in Korean type 2 diabetic patients. Measurement of these renal parameters might be important for early detection of atherosclerosis as well as renal insufficiency in type 2 diabetic patients.