Association between serum cystatin C and diabetic peripheral neuropathy: a cross-sectional study of a Chinese type 2 diabetic population

Hu, Yanyun; Liu, Fang; Shen, Jing; Zeng, Hui; Li, Lianxi; Zhao, Jun; Zhao, Juping; Lu, Fengdi; Jia, Weiping

doi:10.1530/eje-14-0381

Cited by 36 publications

(29 citation statements)

References 25 publications

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“…The levels of NSE [22], CysC [23], and TNF-a [24] are reported to be positively correlated with DPN. Many conditions and diseases (such as tumors, diabetic nephrology, and inflammatory diseases) can affect the serum levels of these markers, and may also overlap with DPN.…”

Section: Discussionmentioning

confidence: 99%

The Association Between Phosphorylated Neurofilament Heavy Chain (pNF-H) and Small Fiber Neuropathy (SFN) in Patients with Impaired Glucose Tolerance

Yan

Han

et al. 2019

Diabetes Ther

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Introduction: Small fiber neuropathy (SFN)the early stage of diabetic peripheral neuropathy (DPN)-progresses gradually and is difficult to diagnose using neurophysiological tests. To facilitate the early diagnosis of SFN, biomarkers for SFN must be identified. The purpose of this study was to investigate the characteristics of SFN in prediabetic patients and the relationship between pNF-H and SFN. Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.9929315.

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Section: Discussionmentioning

confidence: 99%

The Association Between Phosphorylated Neurofilament Heavy Chain (pNF-H) and Small Fiber Neuropathy (SFN) in Patients with Impaired Glucose Tolerance

Yan

Han

et al. 2019

Diabetes Ther

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“…Cystatin-C was shown to be significantly elevated in subjects with peripheral neuropathy. Hu, et al 2014 observed similar finding in Chinese population and inferred that serum Cystatin-C may be a biomarker for peripheral neuropathy [6]. In peripheral neural diseases, Cystatin-C could be released from neurons and affected Schwann cells into endoneurial fluid through the endoneurium.…”

Section: Discussionmentioning

confidence: 73%

“…In peripheral neural diseases, Cystatin-C could be released from neurons and affected Schwann cells into endoneurial fluid through the endoneurium. Hence, elevated serum Cystatin-C concentration may indicate diabetic peripheral nerve injury and associated demyelination [6].…”

Section: Discussionmentioning

confidence: 99%

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Albumin-Creatinine Ratio is More Diagnostic Sensitive than Cystatin-C in Assessment of Diabetic Peripheral Neuropathy

2018

ABBSR

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Background:Diabetic Peripheral neuropathy is one of the most common cardiovascular complications among diabetes mellitus patients and occurs in more than half of the population of diabetic patients world-wide. It is a common cause of foot ulcer, gangrene and amputation among diabetics. Thus, its prevention or early treatment can improve the quality of life of diabetic patients. In a bid to reduce it, various biochemical markers have been evaluated to enable early treatment and amelioration of diabetic neuropathy among diabetes mellitus patients. Aim: Evaluation of the diagnostic relevance of Cystatin-C versus Albumin-creatinine ratio in assessment of Peripheral neuropathy in diabetic type 2 subjects.Method: 102 type 2 DM subjects (66 females and 36 males) and 100 control subjects of same age range (40 -80 years) were recruited for this study which includes 51 subjects with peripheral neuropathy and 51 subjects without peripheral neuropathy. Serum Cystatin-C, Microalbuminuria, Urine creatinine and HBA1c were analysed with standard methods.Results: Cystatin-C, Microalbuminuria, Albumin-creatinine ratio and Glycated haemoglobin were significantly elevated (P<0.05) in diabetic subjects compared to the control. Cystatin-C (ng/ml), microalbuminuria (mg/l), albumin creatinine ratio (mg/mmol) and HBA1c (%) is [105.52 ± 45.11; 90.07±20.29; 10.48 ± 4.82; 6.9±1.7] respectively. Microalbuminuria, albumin creatinine ratio showed significant increase (P<0.05) in subjects with peripheral neuropathy compared to those subjects without [92.11± 22.82; 35.70±16.35; 2.61±1.1; 6.38±1.79]. The ROC curve shows that Albumin-creatinine ratio showed significant (P<0.05) sensitivity to peripheral neuropathy [AUC=0.714] while Cystatin-C showed no significant (P<0.05) sensitivity to peripheral neuropathy complication [AUC=0.553].Conclusion: Cystatin-C was found to be deranged in diabetics. However, Albumin-creatinine ratio showed more diagnostic sensitivity for peripheral neuropathy than Cystatin-C.

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“…Apart from renal function, cystatin C recently has been found to be associated with cardiovascular events . In addition, our previous studies have demonstrated that serum cystatin C was a strong marker for lower limb ischemia and diabetic peripheral neuropathy in Chinese type 2 diabetic patients . However, so far as we know, the association of this small molecular weight protein with the therapeutic DFU outcome remains undetermined, and no ideal serum marker is available to predict the prognosis of DFU.…”

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confidence: 99%

High cystatin C levels predict undesirable outcome for diabetic foot ulcerations

Zhang

et al. 2016

Wound Repair Regeneration

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OBJECTIVES: Cystatin C is growing to be an ideal indicator for renal function and cardiovascular events. The aim of this study was to investigate the relationship between serum Cystatin C levels and the prognosis of diabetic foot ulcerations (DFU). METHOD: Totally 1012 patients with Type 2 diabetes were recruited and divided into two groups: non-diabetic-foot group (NDF, n = 865, 85.5%) and diabetic foot ulcer group (DFU, n = 147, 14.5%). After 1 year follow-up, the patients with DFU were grouped into healing group (n = 110, 74.8%) and non-healing group (n = 37, 25.2%) according to the clinical prognosis. Clinical characteristics and the impact factors of ulcer healing were compared and analyzed. RESULTS: Compared to the cured group, patients in non-healing group were older, had long diabetic duration and significantly higher serum Cystatin C concentrations in DFU (P < 0.01). Multiple logistical regression analysis revealed that Cystatin C was an independent impact factor for non-healing rate of DFU (b =-1.277, P < 0.01). After adjusting for age, duration, renal function, Cystatin C was still linked with increased risk of undesirable DFU outcome (OR = 7.279, 95% CI: 1.299-40.784, P < 0.05). By dividing patients into quar-tiles according to Cystatin C, a downward trend in healing rate was found with increased quartile of serum Cystatin C, there are significant lower healing rate was found in fourth group which was only 57.9% compared with other three groups (P < 0.01). The oddis ratio (OR) analysis showed that the risk of undesirable outcome of DFU in Quartile 4 increased significantly (OR = 4.554, 95% CI: 3.14-5.12, P < 0.05) compared with that of Quartile 1. ROC analysis further indicated that the optimal cutoff of Cystatin C to predict the poor prognosis of DFU was 1.35 mg/L (P < 0.01) with 79.3% of sensitivity and nearly 62% of specificity. CONCLUSIONS: There is a strong and independent association between serum Cys-tatin C and diabetic foot ulceration prognosis, and Cystatin C > 1.35 mg/L predicts more than 6-fold increased risk of incurable foot ulceration. OBJECTIVES: Recent studies highlight a critical interaction between adipocyte fatty acid binding protein (A-FABP) and cardiovascular disorders. However, relationships between serum A-FABP with subclinical atherosclerosis in normal glucose tolerance subjects remain unknown. The study aimed to evaluate the association of serum A-FABP with carotid intima-media thickness (C-IMT) in a Chinese population with normal glucose tolerance. METHOD: 2253 cardiovascular disease-free participants with normal glucose tolerance aged from 20 to 78 years old (835 men, 1418 women) from the Shanghai Obesity Study were enrolled. Serum A-FABP levels were measured by a sandwich enzyme-linked immunosorbent assay. B-mode ultrasound was used to assess C-IMT. RESULTS: Serum A-FABP level was significantly higher in women than men (P < 0.001). Partial correlation analysis showed that serum A-FABP was associated with C-IMT in men, premenopausal and postmenopausal women after adjusting...

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Association between serum cystatin C and diabetic peripheral neuropathy: a cross-sectional study of a Chinese type 2 diabetic population

Cited by 36 publications

References 25 publications

The Association Between Phosphorylated Neurofilament Heavy Chain (pNF-H) and Small Fiber Neuropathy (SFN) in Patients with Impaired Glucose Tolerance

The Association Between Phosphorylated Neurofilament Heavy Chain (pNF-H) and Small Fiber Neuropathy (SFN) in Patients with Impaired Glucose Tolerance

Albumin-Creatinine Ratio is More Diagnostic Sensitive than Cystatin-C in Assessment of Diabetic Peripheral Neuropathy

High cystatin C levels predict undesirable outcome for diabetic foot ulcerations

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