Relationship between Serum Cystatin C and Arterial Stiffness in Type 2 Diabetes Patients with Normal Renal Function

Objective: Several studies showed that increased arterial stiffness is an independent risk factor for cardiovascular disease.Pulse wave velocity (PWV) is known as a marker for large vessel stiffness.Recent studies show that serum cystatin C is associated with PWV and may predict future cardiovascular events, even in subjects with normal renal function.However, there have been few studies for the relationship between cystatin C and arterial stiffness in patients with type 2 diabetes (T2DM).In this study, we investigated the relationship between serum cystatin C and branchial-ankle PWV in T2DM patients with normal renal function.Methods: Patients with urinary albumin/creatinine ratio (ACR) higher than 300 μg albumin/mg creatinine, estimated glomerular filtration rate (eGFR) less than 60 mL/min were excluded.A total of 88 patients (47 male/41 female; age, 59± 2 years; ACR, 33± 5 μg/ mg) were included.Doppler-derived aortic PWV and serum cystatin C were measured.Results: Cystatin C is significantly related to age (r= 0.51, P< 0.001), hemoglobin A1c (r= -0.23, P< 0.05), high density lipoproteincholesterol (r= -0.22,P< 0.05), apoprotein A (r= -0.22,P< 0.05), and eGFR (r= -0.56, P< 0.001).Aortic PWV is significantly associated with age (r= 0.29, P< 0.01), cystatin C (r= 0.33, P< 0.005), and eGFR (r= -0.24, P< 0.05).In multiple regression analysis, there is significant association between aortic PWV and serum cystatin C levels.Conclusion: Serum cystatin C is significantly associated with arterial stiffness in T2DM patients with normal renal function.Our results suggest that cystatin C could be a marker for early atherosclerosis in T2DM patients.