Value of Serum Cystatin C in Predicting Early Renal Impairment in Type 2 Diabetes Iraqi Patients

Abstract

Background: Diabetes mellitus comprises a heterogenous group of metabolic disorders that share the common feature of hyperglycemia due to defects in insulin secretion, insulin action or both. Diabetes mellitus represents the most common metabolic disease worldwide. DM is the most frequent contributor to end stage renal disease. Microalbuminurea is currently the earliest easily detectable laboratory marker of diabetic nephropathy. Cystatin C is a protease inhibitor secreted at a constant rate by cells and released into bloodstream and detected in almost all body fluids. The aim of the present study was to see whether cystain C is elevated before the appearance of microalbuminurea in type 2 diabetic patients.Subjects Materials and Methods: The study was designed to be an observational case control study and was conducted in Al karama teaching hospital in Wassit governorate from January 2015 through November 2015. A random sample of type 2 DM patients was selected with an age range of 43-73 years. A comparable number of 79, 40 males and 39 females, apparently healthy control subjects was randomly selected with an age range of 44-86 years. Serum cystatin was measured for all patients. Results: Mean blood urea and serum creatinine were not significantly different between patient and control group (P>0.05), while mean serum cystatin c was significantly higher in patients than in control group, 0.80+0.18 versus 0.56+0.24 µg/ml, (P<0.001), Serum cystatin c was not significantly affected by, age, gender, weight, serum creatinine, blood urea and HbA1c in both groups.Conclusion: serum cystatin c is a useful marker for early detection of renal function detorioration deterioration in type 2DM patients before the development of microalbuminurea.

Keywords: Cystatin C, type 2 DM