Endocrine Abstracts

Objective: Cystatin C has been proposed as a novel marker of renal function and as a predictor of the severity of coronary atherosclerosis and future cardiovascular events. The aim was to evaluate the possible role of chronic kidney disease and particularly CysC on the characteristics of carotid atherosclerosis in patients with type 2 diabetes (DT2).

Materials and methods: We investigated 195 patients both sexes with DT2 aged 56.54±4.17 years. Control group included 84 healthy subjects the same age. The intima-media thickness (IMT) was measured as the distance between the lumen-intima interface and the media-adventitia interface. Atherosclerotic plaque was defined as a focal structure encroaching into the arterial lumen of 0.5 mm or 50% of the surrounding IMT value. Total plaque area (TPA) was calculated as the sum of all plaque areas. GFR was estimated using the modification of diet in renal disease (MDRD) equation.

Results: Patients were divided into 2 groups by CysC levels tertiles. Patients in the high CysC tertile (n=76) had significantly higher mean carotid IMT (0.88±0.12 mm vs. 0.76±0.07 mm, P=0.03), and TPA (4.69±2.03 mm² vs. 2.71±0.57 mm², P=0.02) compared to patients in the lower tertiles (n=119). CysC levels demonstrated significant positive correlation with the mean carotid IMT (r=0.35, P=0.011). In multivariate analyses adjusted for cardiovascular risk factors, the association between CysC and IMT remained significant (P=0.037). In contrast, neither serum creatinine nor estimated GFR were associated with IMT (P=0.17).

Conclusions: Our study demonstrated a significant association of increased CysC levels with characteristics of carotid atherosclerosis in patients with type 2 diabetes and chronic kidney disease.