Insulin resistance and inflammation may have an additional role in the link between cystatin C and cardiovascular disease in type 2 diabetes mellitus patients

被引：77

作者：

Lee, Seung-Hwan ^{[2
]}

Park, Shin-Ae ^{[2
]}

Ko, Seung-Hyun ^{[2
]}

Yim, Hyeon-Woo ^{[3
]}

Ahn, Yu-Bae ^{[2
]}

Yoon, Kun-Ho ^{[1
]}

Cha, Bong-Yun ^{[1
]}

Son, Ho-Young ^{[1
]}

Kwon, Hyuk-Sang ^{[1
]}

机构：

[1] Catholic Univ Korea, Dept Internal Med, Kangnam St Marys Hosp, Div Endocrinol & Metab, Seoul 137701, South Korea

[2] Catholic Univ Korea, St Vincents Hosp, Dept Internal Med, Div Endocrinol & Metab, Suwon 442723, South Korea

[3] Catholic Univ Korea, Coll Med, Dept Prevent Med, Seoul 137701, South Korea

来源：

METABOLISM-CLINICAL AND EXPERIMENTAL | 2010年 / 59卷 / 02期

关键词：

CHRONIC KIDNEY-DISEASE; RENAL-FUNCTION; RISK-FACTORS; MARKER; DEATH; HEART; CREATININE; EVENTS; GFR; ATHEROSCLEROSIS;

D O I：

10.1016/j.metabol.2009.07.019

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Recent studies suggest that serum cystatin C level is not only a sensitive marker for renal dysfunction but also a predictive marker for cardiovascular disease (CVD) However, the mechanism of this connection is not fully understood We aimed to determine whether insulin resistance or various biomarkers of cardiovascular risk have a role in the link between cystatin C and CVD in type 2 diabetes mellitus patients. Anthropometric measurements and biochemical studies including inflammatory biomarkers were performed in 478 patients with type 2 diabetes mellitus The degree of insulin resistance was assessed by homeostasis model assessment (HOMA-IR) and indicators of metabolic syndrome Estimated glomerulai filtration rate (eGER) was derived from the Modification of Diet in Renal Disease study equation After adjusting for age, sex, body mass index, and eGER, the cystatin C level increased significantly in proportion to the number of metabolic syndrome components present (1.08 +/- 0.06, 1.19 +/- 0.04, 1.20 +/- 0.04, 1.23 +/- 0.04, and 1.37 +/- 0.06 mg/L, P < 0001), and HOMA-IR increased significantly in proportion to cystatm C quartiles (I 16 0 15, 1 40 0 13, I 49 (1 13, and 2 00 0 17, P < 0001) (means SE) Albumn-creatinine ratio. fibrinogen, uric acid. homocysteine, high-sensitivity C-reactive protein, and lipoprotein(a) all showed significant correlations with cystatm C that were generally higher than those with eGFR Cystatin C level was independently associated with HOMA-IR (beta = 0.0380, P = 0082), albumin-mainline ratio (beta = 0.0004, P < 0001), uric acid (beta = 0.0666, P < .0001), and homocysteme (beta = 0 0087, P = 0004) In conclusion, cystatm C level was significantly associated with insulin resistance and biomarkers reflecting inflammation independent of renal function These components may have a role in addition to that of eGER in explaining the link between cystatm C and CVD in type 2 diabetes mellitus patients (C) 2010 Elsevier Inc All rights reserved.

引用

页码：241 / 246

页数：6

共 32 条

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