Elevated cystatin C concentration and progression to pre-diabetes: the Western New York study.

Abstract

OBJECTIVE:

We conducted a nested case-control investigation to examine whether elevated baseline concentrations of cystatin C predicted progression from normoglycemia to pre-diabetes over 6 years of follow-up from the Western New York Health Study.

RESEARCH DESIGN AND METHODS:

In 2002-2004, 1,455 participants from the Western New York Health Study, who were free of type 2 diabetes and known cardiovascular disease at baseline (1996-2001), were reexamined. An incident case of pre-diabetes was defined as an individual with fasting glucose < 100 mg/dl at the baseline examination and > or = 100 and < or = 125 mg/dl at the follow-up examination, thereby eliminating individuals with prevalent pre-diabetics. All case patients (n = 91) were matched 1:3 to control participants based on sex, race/ethnicity, and year of study enrollment. All control subjects had fasting glucose levels < 100 mg/dl at both baseline and follow-up examinations. Cystatin C concentrations and the urinary albumin-to-creatinine ratio were measured from frozen (-196 degrees C) baseline blood and urine samples. Serum creatinine concentrations were available from the baseline examination only.

RESULTS:

Multivariate conditional logistic regression analyses adjusted for age, baseline glucose level, homeostasis model assessment of insulin resistance, BMI, hypertension, estimated glomerular filtration rate, cigarette smoking, and alcohol use revealed a significantly increased risk of progression to pre-diabetes among those with elevated baseline concentrations of cystatin C (odds ratio 3.28 [95% CI 1.43-7.54]) (upper quintile versus the remainder). Results of secondary analyses that considered high-sensitivity C-reactive protein, interleukin-6, E-selectin, or soluble intercellular adhesion molecule-1 did not alter these results.

CONCLUSIONS:

These results suggest that cystatin C was associated with a threefold excess risk of progression to pre-diabetes in this population.

• Authors: Richard P Donahue, Saverio Stranges, Karol Rejman, Lisa B Rafalson, Jacek Dmochowski, Maurizio Trevisan
• Journal: Diabetes care (Diabetes Care) Vol. 30 Issue 7 Pg. 1724-9 (Jul 2007) ISSN: 1935-5548 [Electronic] United States
• PMID: 17456840 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• CST3 protein, human
• Cystatin C
• Cystatins

Topics

• Aged
• Case-Control Studies
• Cystatin C
• Cystatins (blood, urine)
• Disease Progression
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prediabetic State (blood, urine)
• Predictive Value of Tests