European Journal of Epidemiology

, Volume 28, Issue 9, pp 775–778 | Cite as

High cystatin C levels predict severe retinopathy in type 2 diabetes patients

  • Rui He
  • Jing Shen
  • Jun Zhao
  • Hui Zeng
  • Lianxi Li
  • Jungong Zhao
  • Fang LiuEmail author
  • Weiping JiaEmail author
Letter to the Editor

Diabetes mellitus affects over 18.2 million people (or 6.3 % of the total population) in the US and over 800,000 new cases of type 2 diabetes are diagnosed every year [1]. Meanwhile, diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes, resulting in blindness for over 10,000 people with diabetes per year [1]. Cystatin C is a member of the cystatin superfamily of cystine protease inhibitors, which are produced by nucleated cells at a constant rate [2]. Evidences have shown that serum cystatin C could predict early prognostic stages of diabetic nephropathy (DN) [3] and was implicated in the mechanism of age-related macular degeneration (AMD) [4]. Charumathi et al. recently reported that elevated levels of serum cystatin C were associated with prediabetes in a nationally representative sample of non-obese US adults [5]. In order to investigate the relationship between cystatin C and diabetic retinopathy (DR) to clarify the predictive value of...


Diabetic Retinopathy Multiple Logistic Regression Analysis Diabetes Duration Serum Cystatin Postprandial Plasma Glucose 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This work was supported by Grants (Nos. 81270397 and 81070650) from the Natural Science Foundation of China.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10654_2013_9839_MOESM1_ESM.doc (120 kb)
Supplementary material (DOC 117 kb)


  1. 1.
    Fong DS, Aiello LP, Ferris FL III, R Klein. Diabetic retinopathy. Diabetes care. 2004;27(10):2540–53.PubMedCrossRefGoogle Scholar
  2. 2.
    Barrett AJ, Davies ME, Grubb A. The place of human gamma-trace (cystatin C) amongst the cysteine proteinase inhibitors. Biochem Biophys Res Commun. 1984;120(2):631–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Shimizu A, Horikoshi S, Rinnno H, Kobata M, Saito K, Tomino Y. Serum cystatin C may predict the early prognostic stages of patients with type 2 diabetic nephropathy. J Clin Lab Anal. 2003;17(5):164–7. doi: 10.1002/jcla.10087.PubMedCrossRefGoogle Scholar
  4. 4.
    Paraoan L, Hiscott P, Gosden C, Grierson I. Cystatin C in macular and neuronal degenerations: implications for mechanism(s) of age-related macular degeneration. Vision Res. 2010;50(7):737–42. doi: 10.1016/j.visres.2009.10.022.PubMedCrossRefGoogle Scholar
  5. 5.
    Sabanayagam C, Wong TY, Xiao J, Shankar A. Serum cystatin C and prediabetes in non-obese US adults. European journal of epidemiology. 2013. doi: 10.1007/s10654-013-9781-3.
  6. 6.
    American Diabetes A. Standards of medical care in diabetes—2012. Diabetes Care. 2012;35(Suppl 1):S11–63. doi: 10.2337/dc12-s011.Google Scholar
  7. 7.
    Mussap M, Plebani M. Biochemistry and clinical role of human cystatin C. Crit Rev Clin Lab Sci. 2004;41(5–6):467–550. doi: 10.1080/10408360490504934.PubMedCrossRefGoogle Scholar
  8. 8.
    Bandello F, Lattanzio R, Zucchiatti I, Del Turco C. Pathophysiology and treatment of diabetic retinopathy. Acta Diabetol. 2013;50(1):1–20. doi: 10.1007/s00592-012-0449-3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Department of Endocrinology and MetabolismShanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai Key Laboratory of DiabetesShanghaiChina
  2. 2.Department of Vascular SurgeryShanghai Jiaotong University Affiliated Sixth People’s HospitalShanghaiChina
  3. 3.Department of Interventional RadiologyShanghai Jiaotong University Affiliated Sixth People’s HospitalShanghaiChina

Personalised recommendations