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Cystatin C: Not Only a Kidney Marker but Also a Potential Early Indicator of Metabolic Alterations in Childhood

Angelika Mohn, Giada Di Pietro, Alessandro Maggitti

    Hormone Research in Paediatrics
    |August 11, 2026
    PubMed

    Insights

    High cystatin C levels in obese children are linked to central adiposity and insulin resistance (IR). This suggests cystatin C may serve as an early indicator of metabolic and kidney risk in pediatric obesity.

    Area of Science:

    • Pediatric Endocrinology
    • Nephrology
    • Metabolic Health

    Background:

    • Pediatric obesity presents challenges in identifying early metabolic and kidney dysfunction.
    • Cystatin C is a potential biomarker for both renal and metabolic health.

    Purpose of the Study:

    • To investigate the association between cystatin C and adiposity, insulin resistance (IR), and cardiometabolic risk in overweight/obese children.
    • To evaluate cystatin C as a potential early marker in pediatric obesity.

    Main Methods:

    • Retrospective cross-sectional study of 169 overweight/obese children.
    • Analysis of anthropometric, blood pressure, renal, glucose/insulin, and lipid parameters.
    • Stratification by cystatin C tertiles and stepwise regression for predictor identification.

    Main Results:

    • Highest cystatin C tertile associated with increased BMI-SDS, waist circumference, blood pressure SDS, and iCARE index.
    • Elevated HOMA-IR, fasting glucose-to-insulin ratio, and TG:HDL ratio observed in highest tertile.
    • Waist circumference and HOMA-IR identified as independent predictors of cystatin C.

    Conclusions:

    • Elevated cystatin C is independently associated with central adiposity and IR in pediatric obesity.
    • Cystatin C shows potential as an integrated early marker for metabolic and kidney risk in this population.
    Abstract

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