FAN Chun-yi,SUN Xiao-ting,QIAN Chun-hua,et al.Correlation between cystatin C and carotid atherosclerosis in patients with type 2 diabetes mellitus in community[J].同济大学学报（医学版）,2021,42(2):243-247. [点击复制]
Correlation between cystatin C and carotid atherosclerosis in patients with type 2 diabetes mellitus in community
FAN Chun-yi,SUN Xiao-ting,QIAN Chun-hua,QU Shen,XU Wei-gang,BU Le
(Dept. of Endocrinology, Shanghai Tenth Peoples Hospital, School of Medicine, Tongji University, Shanghai 200072, China; Pengpu Xincun Community Health Service Center, School of Medicine, Tongji University, Shanghai 200435, China;School of Medicine, Tongji University, Shanghai 200092, China)
Abstract:
ObjectiveTo analyze the relationship between cystatin C（Cys C) and carotid atherosclerosis in patients with type 2 diabetes mellitus（T2DM) in the community. MethodsClinical data of 281 T2DM patients with stable blood glucose, who visited Pengpu Xincun Community Health Service Center from January 2018 to December 2019, were collected. The carotid intima-media thickness（CIMT) was measured by vascular ultrasonography, there were 49 patients with CIMT<0.9 mm and 232 patients with CIMT≥0.9 mm. The blood pressure, blood lipid, blood glucose, glycosylated hemoglobin, homocysteine, resistance index and creatinine were compared between two groups. Logistic regression was used to analyze the risk factors of carotid atherosclerosis, and receiver operating characteristic curve（ROC) was used to predict the risk of carotid atherosclerosis. ResultsThe age, uric acid, homocysteine, Cys C and resistance index of CIMT≥0.9 mm group were significantly higher than those of CIMT<0.9 mm group, and high-density lipoprotein value was significantly lower than that of CIMT<0.9 mm group（P<0.05). There were no significant differences in diabetes duration, body mass index, blood pressure, fasting blood glucose, glycosylated hemoglobin, total cholesterol, triglyceride and low-density lipoprotein between the two groups（P>0.05). Pearson correlation analysis showed that Cys C was positively correlated with age, BMI, homocysteine, uric acid, triglyceride, carotid intimal thickness（r=0.249, 0.341, 0.416, 0.416, 0.133, 0.219, P<0.001), resistance index（r=0.153, P<0.010), creatinine（r=0.585, P<0.001) in T2DM patients, but negatively correlated with HDL（r=-0.245, P<0.001). ROC curve analysis showed that the area under the curve was 0.632（95%CI： 0.552-0.712, P=0.004) when Cys C was 0.845 mg/L as the diagnostic cut-off value. The sensitivity was 36.3% and the specificity was 87.2%. Logistic regression analysis showed that age≥65 years（OR=3.014, 95%CI： 1.586-5.726), HbA1c≥6.5%（OR=1.719,95%CI： 1.003-2.946), resistance index≥0.75（OR=3.109,95%CI： 1.621-5.961), serum Cys C≥0.845（OR=2.013,95%CI： 1.097-3.693) were independent risk factors for carotid atherosclerosis. The area under ROC curve（AUC) of Cyst combined multiple indicators for predicting risk of carotid atherosclerosis was 0.752（95%CI： 0.684-0.82) . ConclusionThere is a correlation between serum Cys C and carotid atherosclerosis in T2DM patients. The established model consisted of Cyst and other indicators can be used to predict risk of carotid atherosclerosis in T2DM patients with stable blood glucose.
