Endocrine Abstracts (2012) 29 P642

Cystatin C and TGF-[alpha] as a biomarker of diabetic nephropathy in normo and microalbuminuric patients

A Dogruk Unal, M Takir, P Hulya, O Tarcin, N Bayraktar, E Erdogan & N Guvener Demirag

Baskent University Hospital, Istanbul, Turkey.

Background and aims: This study was done to predict renal impairment in type 2 diabetic patients with normo or microalbuminuria by detection of serum cystatin C, serum and urinary TGF-β levels.

Material and methods: Seventy-eight patients were categorized into four groups depending on urinary albumin excretion and eGFR: eGFR <60 ml/min per 1.73 m2 with normoalbuminuria in group 1; eGFR was <60 or >60 ml/min per 1.73 m2 with microalbuminuria in group 2; normoalbuminuria in group 3 and 4 patients with eGFR >120 and eGFR between 90–120 ml/min per 1.73 m2 respectively.

Results: Baseline characteristics of subjects are shown in Table 1. Although blood glucose regulation was best, blood urea, serum creatinine were higher and eGFR was significantly lower in group 1. While serum cystatin C level was significantly high in group 1, serum and urinary TGF-β levels were high in group 2.

Conclusion: Although urinary albumin excretion is suggested for detection of type 2 diabetic nephropathy, there is subgroup of patients with impaired renal function without increased urinary albumin excretion. This study showed that serum cystatin C level could be used as an early biomarker of diabetic nephropathy in normoalbuminuric patients.

M, male; F, female; BUN, blood urea nitrogen; Cr, Creatinin; HDL, high-density lipoprotein; LDL, low-density lipoprotein; TG, triglyceride; TGF, transforming growth factor.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Table 1 Baseline demagrophic, metabolic and laboratory parameters of patients.
Group 1Group 2Group 3Group 4P value
Sex (M/F)10/1010/1115/210/100.039
Age (years)62.9±5.859.7±6.949.0±8.053.7±8.30.001
BMI (kg/m2)29.6±4.232.0±5.332.2±6.631.6±5.40.43
Diabetic duration (months)116.4±100.1127.4±96.796.0±71.878.0±45.10.243
Glukoz (mg/dl)118.8±26.6152.1±62.7143.9±42.6121.1±32.70.043
HbA1c (%)6.1±0.76.9±1.27.3±1.16.7±1.30.028
BUN (mg/dl)21.5±6.717.8±7.213.5±2.813.7±3.40.001
Serum Cr (mg/dl)1.2±0.20.9±0.30.6±0.00.6±0.10.001
hsCRP (mg/dl)5.1±4.5 6.0±7.75.5±5.55.6±5.20.969
Total kolesterol (mg/dl)171.3±46.5182.8±35.9203.8±32.9186.2±35.40.109
HDL (mg/dl)41.2±10.138.4±7.839.8±10.940.5±5.70.774
LDL (mg/dl)102.6±35.5115.3±34.3129.6±30.3105.9±29.60.079
TG (mg/dl)148.3±91.1174.8±79.9175.9±50.9184.6±68.10.074
Serum TGF-β (ng/ml)16.7±6.918.9±3.0116.1±6.113.2±6.40.022
Urinary TGF-β (pg/mg cr)558.6±230.0633.2±100.6539.3±204.3442.2±214.30.022
Cystatin C (mg/l)1.4±0.61.1±0.40.6±0.10.7±0.10.001
Urinary microalbumin (mg/day)18.0±5.989.8±37.722.2±8.916.3±5.10.001
eGFR (ml/min per 1.73 m2)54.7±7.678.2±23.5125.7±6.9106.1±29.80.001

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