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Relationship between cystatin C and coronary artery atherosclerosis progression differs by type 1 diabetes

David M Maahs1, Janet K Snell-Bergeon, John E Hokanson

  • 1Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado 80045, USA. David.Maahs@uchsc.edu

Diabetes Technology & Therapeutics
|January 20, 2010
PubMed

Insights

Cystatin C

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Cystatin C is a potential biomarker for renal function and cardiovascular disease (CVD).
  • Previous research suggests cystatin C may predict CVD better than serum creatinine.
  • This study examines cystatin C's association with coronary artery atherosclerosis (CA) progression in type 1 diabetes (T1D) versus non-diabetic individuals.

Purpose of the Study:

  • To determine if the relationship between cystatin C and CA progression differs between individuals with T1D and those without diabetes.
  • To investigate cystatin C as a predictor of CA progression in distinct glycemic status groups.

Main Methods:

  • Coronary artery calcium (CAC) was measured twice over approximately 2.4 years in 1,123 participants (45% with T1D).
  • CA progression was defined by changes in CAC volume score or clinical diagnosis.
  • Stepwise logistic regression analyzed the association of cystatin C with CA progression, stratified by T1D status.

Main Results:

  • While univariate analysis showed similar associations of cystatin C with CA progression in both groups, multivariate analysis revealed a significant difference (P=0.01) by T1D status.
  • In individuals without diabetes, higher cystatin C was unexpectedly linked to decreased CA progression (OR=0.65), particularly after adjusting for body mass index (BMI).
  • Adjustment for BMI significantly altered the association between cystatin C and CA progression in the non-diabetic group.

Conclusions:

  • The relationship between cystatin C, BMI, and CA progression is complex and differs between individuals with and without T1D.
  • Further research is needed to elucidate the interplay of these factors in cardiovascular risk assessment.
  • Hypothesis-generating data suggest potential differential roles of cystatin C in atherosclerosis progression based on diabetes status.
Abstract

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