OVERVIEW OF CYSTATIN C’S ROLE IN MONITORING RENAL FUNCTION IN TYPE 2 DIABETES AND THE FACTORS THAT AFFECT TEST RESULTS
Nội dung chính của bài viết
Tóm tắt
Objectives: This overview aims to summarize the role of Cystatin C test in assessing the renal function
in patients with type 2 diabetes mellitus (T2DM), and to identify factors influencing cystatin C levels.
Research methods: A scoping review was conducted using PubMed and Google Scholar to identify
studies published between January 2015 and December 2023. Keywords included “cystatin C”, “type 2
diabetes”, and “renal/kidney disease”. Eligible studies involved patients with T2DM and reported the use
or evaluation of cystatin C in renal function assessment.
Results: Research on the use of the cystatin C test to evaluate renal function in people with type 2
diabetes has increased in recent years, peaking in 2022 with four studies (19%). The majority of studies
were conducted in China (38.1%; n = 8). Of the 21 studies reviewed, 13 (61.9%) reported that cystatin C is
useful for the early detection of renal disease, and 14 (66.7%) indicated that cystatin C offers advantagesas well as greater sensitivity and specificity-compared with creatinine in assessing renal function. Factors
such as muscle mass, age, sex, race, and duration of diabetes were found not to influence cystatin C levels.
However, certain conditions, including obesity, cardiovascular disease, and hypertension, were shown to
affect cystatin C test results.
Conclusions: Cystatin C serves as a complementary biomarker to creatinine for evaluating renal function,
supporting monitoring, early detection of renal impairment, and estimation of glomerular filtration rate in
patients with type 2 diabetes. Unlike serum creatinine, cystatin C is not influenced by factors such as
muscle mass, age, sex, race, or disease duration, making it a more dependable indicator. However, certain
conditions-including obesity, cardiovascular disease, and hypertension-can affect cystatin C levels..
Chi tiết bài viết
Từ khóa
Cystatin C, type 2 diabetes mellitus, renal function, diabetic renal disease
Tài liệu tham khảo
Wu HQ. Association between cystatin C and diabetic
retinopathy among type 2 diabetic patients in China:
A Meta-analysis. Int J Ophthalmol. 2021;14(9):1430-40.
2. Zhao J, Deng W, Zhang Y, Zheng Y, Zhou L,
Boey J, and colleagues Association between Serum
Cystatin C and Diabetic Foot Ulceration in Patients
with Type 2 Diabetes: A Cross-Sectional Study. J
Diabetes Res. 2016; 2016:8029340.
3. Huang Z, Zhong J, Zhang S, Xiong Z, Huang
Y, Liu M, and colleagues Association between serum
cystatin C and early impairment of cardiac function
and structure in type 2 diabetes patients with normal
renal function. Clin Cardiol. 14 September 2022;
45(12):1287-96.
4. Ma CC, Duan CC, Huang RC, Tang HQ.
Association of circulating cystatin C levels with
type 2 diabetes mellitus: a systematic review and
meta-analysis. Arch Med Sci AMS. 11 March
2019;16(3):648-56.
5. Murai T, Takebe N, Nagasawa K, Todate Y,
Nakagawa R, Nakano R, and colleagues Association
of epicardial adipose tissue with serum level of
cystatin C in Type 2 diabetes. PLoS ONE. 18
September 2017;12(9): e0184723.
6. Wang S, Liu Q, Guo F, Zhou X, Shi J, Xie
Q. Clinical utility of serum cystatin C for prediction
of multi-vessel disease by coronary angiography in
type 2 diabetes mellitus patients with normal renal
function. BMC Cardiovasc Disord. 19 April 2020;
20:183.
7. Sapkota S, Khatiwada S, Shrestha S, Baral
N, Maskey R, Majhi S, and colleagues Diagnostic
Accuracy of Serum Cystatin C for Early Recognition
of Nephropathy in Type 2 Diabetes Mellitus. Int J
Nephrol. 26 April 2021; 2021:8884126.
8. Javanmardi M, Azadi NA, Amini S, Abdi M.
Diagnostic value of cystatin C for diagnosis of early
renal damages in type 2 diabetic mellitus patients:
The first experience in Iran. J Res Med Sci Off J
Isfahan Univ Med Sci. June 2015; 20(6):571-6.
9. Dejenie TA, Abebe EC, Mengstie MA, Seid
MA, Gebeyehu NA, Adella GA, and colleagues.
Dyslipidemia and serum cystatin C levels as
biomarker of diabetic nephropathy in patients with
type 2 diabetes mellitus. Front Endocrinol. 4 April
2023; 14:1124367.
10. Asmamaw T, Genet S, Menon M, Tarekegn
G, Chekol E, Geto Z, and colleagues. Early Detection
of Renal Impairment Among Patients with Type 2
Diabetes Mellitus Through Evaluation of Serum
Cystatin C in Comparison with Serum Creatinine
Levels: A Cross-Sectional Study. Diabetes Metab
Syndr Obes Targets Ther. 3 January 2020; 13:4727-
35.
11. Bui TTH, Nguyen TG. The value of Cystatin
C in early diagnosis of kidney damage in patients with
Type 2 diabetes at Thai Nguyen Central Hospital.
Vietnam Study Magazine [Internet]. May 5, 2021
[cited September 18, 2023]; 498(2)
12. Dao DA, Dang TH, Nguyen TT. Clinical
value of serum Cystatin C in predicting glomerular
filtration rate in patients with type 2 diabetes. Vietnam
J Diabetes Endocrinol. 2020; (41):79-87.
13. Ngan DTK, Quan DT. Correlation between
blood Cystatin C concentration and some paraclinical
indices in patients with type 2 diabetes. Vietnam J
Diabetes Endocrinol. 1 Jul 2023; (61):130-5.
14. Li S, Liu J, Liu Y, Chen K, Chen S, Tu M, and
colleagues. Prognostic value of creatinine-to-cystatin
c ratio in patients with type 2 diabetes mellitus: a
cohort study. Diabetol Metab Syndr. 23 November
2022; 14:176.
15. Wang N, Lu Z, Zhang W, Bai Y, Pei D, Li L.
Serum Cystatin C Trajectory Is a Marker Associated
with Diabetic Kidney Disease. Front Endocrinol. 11
May 2022; 13:824279.
16. Bacci MR, Chehter EZ, Azzalis LA, Costa
de Aguiar Alves B, Fonseca FLA. Serum NGAL and Cystatin C Comparison with Urinary Albuminto-Creatinine Ratio and Inflammatory Biomarkers
as Early Predictors of Renal Dysfunction in Patients
with Type 2 Diabetes. Kidney Int Rep. 15 October
2016; 2(2):152-8.
17. Dang AD, Tran HD. Study of renal function
in type 2 diabetic patients by serum Cystatin C. J
Med Pharm. January 2017; 44-51.
18. Yassine HN, Trenchevska O, Dong Z,
Bashawri Y, Koska J, Reaven PD, and colleagues.
The association of plasma cystatin C proteoforms
with diabetic chronic kidney disease. Proteome Sci.
25 March 2016; 14:7.
19. Tsaryk I, Pashkovska N. The role of renal
damage markers in the diagnosis of early stages of
kidney injury in patients with latent autoimmune
diabetes in adults. J Med Life. June 2022; 15(6):792-6.
20. Jhatta C, Girdhar J, Gupta S, Verma I. To
Compare the Level of Cystatin C in Type 2 Diabetes
Mellitus with Obesity. Indian J Endocrinol Metab.
2020; 24(4):312-8.
21. Qian T, Tian L, Li Y, Zhang Z, Tian X, Sun
D. Value of the combined examination of Cys-C and
HbA1c for diagnosis of early renal injury in pediatric
diabetes. Exp Ther Med. February 2017;13(2):515-8.