Association Of Cystatin C With Subclinical Cardiovascular Disease In Patients With Type 2 Diabetes Mellitus: A Clinical Study

Background and aim: We selected carotid atherosclerotic plaque(CAP)as a marker of subclinical cardiovascular disease to investigate the association cystatin C(CysC)with subclinical cardiovascular disease(SCVD)with type 2 diabetes mellitus(T2DM).Method: 1020 electronic records of patients from physical examination center and endocrinology inpatients with T2 DM in our hospital from June to July 2016 were collected.BMI,waist circumference(WC),hip circumference(HC),the main biochemical indexes(including fasting blood glucose(FPG),glycosylated hemoglobin(Hb A1c),blood urea,serum creatinine(Scr),cystatin C(CysC),triglyceride(TG),cholesterol(TC),low density lipoprotein(LDL)high density lipoprotein(HDL),and homocysteine(HCY),high sensitivity C-reactive protein(Hs-CRP)and the carotid atherosclerotic plaques(CAP)were collected.The observation group was T2 DM with CAP(T2DM-CAP),the control groups were T2 DM without CAP(T2DM-NCAP),non-T2 DM with CAP(NT2DM-CAP)and non-T2 DM without CAP(T2DM-NCAP),the case group and the control groups were matched as a ratio of 1:1 according to the same sex and ±5 years old.In the cases of repeated admissions,we chose only the first admission that was eligible for the study.Results: 1)Compared the other 3 control groups,the observation group had significantly(Hb A1C),e GFR and CysC(P <0.05).2)Compared the T2DM-NCAP(P=0.021),T2DM-NCAP group had significantly lower Hb A1 C,e GFR and CysC;blood lipids,HCY,Hs-CRP,WC and HC were not significantly different;Compared with NT2DM-CAP and NT2DM-NCAP groups,the observation group had significantly different WC,Hb A1 C,FPG,TC,TG,Scr,e GFR,CysC(P<0.05).3)The percentages of patients with poor blood glucose control and good blood glucose control groups with CAP of T2 DM patients were 60.6% and 38.3%,respectively.4)The values of CysC between the four groups were 1.16 ± 0.73,0.88 ± 0.26,0.94 ± 0.29,0.89 ± 0.19,and they were significantly different(P=0.004).5)A independent risk factor for CAP with T2 DM was CysC(OR=4.759,P=0.001).6)Scr,elderly,abdominal obesity,Hs-CRP were positively correlated with CysC,but e GFR was negatively correlated.7)We selected CysC as the test variable to develop the ROC curve of the CAP in patients with T2 DM,the area under the curve was 0.552 and the P value was 0.189.Conclusions: 1)Lower e GFR?Higher CysC?Hb A1c(?7%)were associated with CAP with T2 DM.2)CysC was associated with CAP formation both T2 DM and non-T2 DM.3)CysC was an independent risk factor for T2 DM with CAP formation.4)CysC was positively correlated with abdominal obesity,Hs-CRP.5)CysC had no diagnostic significance for CAP with T2 DM.