Skip to main content

Advertisement

SpringerLink
Log in

Cystatin C predicts diabetic retinopathy in Chinese patients with type 2 diabetes

  • Original Article
  • Published:
International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

This study aims to identify the predictive value of cystatin C for diabetic retinopathy (DR) in Chinese patients with type 2 diabetes. Data from a cross-sectional hospital-based survey of 450 type 2 diabetes patients were analyzed in the study. DR was assessed by fundus fluorescein angiography. Duration of diabetes and other related information were obtained by questionnaire. Body mass index, blood pressure, HbA1c, cystatin C, glomerular filtration rate, urinary albumin excretion, blood lipids, and uric acid were measured. Binary logistic regression was performed to evaluate potential risk factors for DR. The predictive value of cystatin C for DR was evaluated using ROC curve. Cystatin C (P = 0.039) was a risk factor for DR after GFR, and other possibly related variables were adjusted. Cystatin C had a significant predictive value for any DR (AUC, 0.763, P < 0.001; optimal cutoff value, 1.11 mg/L; sensitivity, 56.00 %; specificity, 83.90 %) or severe DR (AUC, 0.821, P < 0.001; optimal cutoff value, 1.23 mg/L; sensitivity, 73.60 %; specificity, 88.70 %). Cystatin C is a novel risk factor for DR and should be used to screen and forecast the presence of DR (especially severe DR) in Chinese patients with type 2 diabetes. The association between cystiatin C and DR should not depend on the excellent ability of cystatin C for the estimation of GFR.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kocur I, Resnikoff S. Visual impairment and blindness in Europe and their prevention. Br J Ophthalmol. 2002;86:716–22.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  2. Hirsch IB, Brownlee M. Beyond hemoglobin A1c-need for additional markers of risk factor for diabetic microvascular complications. JAMA. 2010;303:2291–2.

    Article  PubMed  CAS  Google Scholar 

  3. Pucci L, Triscornia S, Lucchesi D, Fotino C, Pellegrini G, Pardini E, et al. Cystatin C and estimates of renal function: searching for a better measure of kidney function in diabetic patients. Clin Chem. 2007;53:480–8.

    Article  PubMed  CAS  Google Scholar 

  4. Jeon YK, Kim MR, Huh JE, Mok JY, Song SH, Kim SS, et al. Cystatin C as an early biomarker of nephropathy in patients with type 2 diabetes. J Korean Med Sci. 2011;26:258–63.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  5. He R, Shen J, Zhao J, Zeng H, Li LX, Zhao JG, et al. High Cystatin C levels predict severe retinopathy in type 2 diabetes patients. Eur J Epidemiol. 2013;28:775–8.

    Article  PubMed  Google Scholar 

  6. Namperumalsamy P, Nirmalan PK, Ramasamy K. Developing a screening program to detect sight-threatening diabetic retinopathy in South India. Diabetes Care. 2003;26:1831–5.

    Article  PubMed  Google Scholar 

  7. Zhang H, Wang J, Ying GS, Shen L, Zhang Z. Diabetic retinopathy and renal function in Chinese type 2 diabetic patients. Int Urol Nephrol. 2014;46:1375–81.

    Article  PubMed  CAS  Google Scholar 

  8. Wilkinson CP, Ferris 3rd FL, Klein RE, Lee PP, Agardh CD, Davis M, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003;110:1677–82.

    Article  PubMed  CAS  Google Scholar 

  9. Bandello F, Lattanzio R, Zucchiatti I, Del Turco C. Pathophysiology and treatment of diabetic retinopathy. Acta Diabetol. 2013;50:1–20.

    Article  PubMed  CAS  Google Scholar 

  10. Spranger J, Kroke A, Möhlig M, Hoffmann K, Bergmann MM, Ristow M, et al. Inflammatory cytokines and the risk to develop type 2 diabetes: results of the prospective population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Diabetes. 2003;52:812–7.

    Article  PubMed  CAS  Google Scholar 

  11. Gardner TW, Antonetti DA, Barber AJ, Lanoue KF, Nakamura M. New insights into the pathophysiology of diabetic retinopathy: potential cell-specific therapeutic targets. Diabetes Technol Ther. 2000;2:601–4.

    Article  PubMed  CAS  Google Scholar 

  12. Yuuki T, Kanda T, Kimura Y, Kotajima N, Tamura J, Kobayashi I, et al. Inflammatory cytokines in vitreous fluid and serum of patients with diabetic vitreoretinopathy. J Diabetes Complications. 2001;15:257–9.

    Article  PubMed  CAS  Google Scholar 

  13. Paraoan L, Hiscott P, Gosden C, Grierson I. Cystatin C in macular and neuronal degenerations: implications for mechanism(s) age-related macular degeneration. Vis Res. 2010;50:737–42.

    Article  PubMed  CAS  Google Scholar 

  14. Wassélius J, Johansson K, Håkansson K, Abrahamson M, Ehinger B. Cystatin C uptake in the eye. Graefes Arch Clin Exp Ophthalmol. 2005;243:583–92.

    Article  PubMed  Google Scholar 

  15. Van Hecke MV, Dekker JM, Nijpels G, Moll AC, Heine RJ, Bouter LM, et al. Inflammation and endothelial dysfunction are associated with retinopathy: the Hoorn Study. Diabetologia. 2005;48:1300–6.

    Article  PubMed  CAS  Google Scholar 

  16. Taglieri N, Koenig W, Kaski JC. Cystatin C and cardiovascular risk. Clin Chem. 2009;55:1932–43.

    Article  PubMed  CAS  Google Scholar 

  17. Mussap M, Plebani M. Biochemistry and clinical role of human Cystatin C. Crit Rev Clin Lab Sci. 2004;41:467–550.

    Article  PubMed  CAS  Google Scholar 

  18. The Diabetic Retinopathy Study Research Group. Preliminary report on the effects of photocoagulation therapy. Am J Ophthalmol. 1976;81:383–96.

    Article  Google Scholar 

  19. The Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy; clinical applications of Diabetic Retinopathy Study. Ophthalmology. 1981;88:583–600.

    Article  Google Scholar 

  20. Pavkov ME, Knowler WC, Lemley KV, Mason CC, Myers BD, Nelson RG. Early renal function decline in type 2 diabetes. Clin J Am Soc Nephrol. 2012;7:78–84.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  21. Hu A, Luo Y, Guo XB, Ding XY, Zhu XB, Wang XQ, et al. Low serum apolipoprotein A1/B ratio is associated with proliferative diabetic retinopathy in type 2 diabetes. Graefes Arch Clin Exp Ophthalmol. 2012;250:957–62.

    Article  PubMed  CAS  Google Scholar 

  22. Sasongko MB, Wong TY, Nguyen TT, Shaw JE, Jenkins AJ, Wang JJ. Novel versus traditional risk markers for diabetic retinopathy. Diabetologia. 2012;55:666–70.

    Article  PubMed  CAS  Google Scholar 

  23. Deguchi Y, Maeno T, Saishin Y, Hori Y, Shiba T, Takahashi M. Relevance of the serum apolipoprotein ratio to diabetic retinopathy. Jpn J Ophthalmol. 2011;55:128–31.

    Article  PubMed  CAS  Google Scholar 

  24. Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet. 2010;376:124–36.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by grants from the research development program of Shandong provincial higher schools of China (Project Number: J12LM61).

Conflict of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, 250021, Shandong, China

    Shijie Sun, Minglong Li & Jie Zhou

  2. College of Medicine and Nursing, Dezhou University, Dezhou, 253023, Shandong, China

    Shijie Sun

  3. Department of Clinical Pharmacology and Toxicology, University Hospital, Zurich, 999034, Switzerland

    Zhibo Gai

  4. Diabetes Centre, Dezhou People’s Hospital, Dezhou, 253000, Shandong, China

    Haiyan Shi & Qing Zhao

  5. Clinical Laboratory, Dezhou People’s Hospital, Dezhou, 253000, Shandong, China

    Jun Tian

Authors
  1. Shijie Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Minglong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jie Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhibo Gai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Haiyan Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Qing Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jun Tian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Minglong Li.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sun, S., Li, M., Zhou, J. et al. Cystatin C predicts diabetic retinopathy in Chinese patients with type 2 diabetes. Int J Diabetes Dev Ctries 35 (Suppl 3), 398–404 (2015). https://doi.org/10.1007/s13410-015-0383-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13410-015-0383-3

Keywords

Search

Navigation