HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: dc07-0040v1 30/7/1724    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Donahue, R. P. Articles by Trevisan, M. Search for Related Content PubMed PubMed Citation Articles by Donahue, R. P. Articles by Trevisan, M. Social Bookmarking                What's this?

Elevated Cystatin C Concentration and Progression to Pre-Diabetes

The Western New York Study

¹ Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, New York
² Clinical Science Research Institute, Warwick Medical School, Coventry, U.K.
³ Department of Mathematics and Statistics, University of North Carolina Charlotte, Charlotte, North Carolina

Address correspondence and reprint requests to Richard P. Donahue, PhD, MPH, Department of Social and Preventive Medicine, School of Public Health and Health Professions, State University of New York at Buffalo, 3435 Main St., Farber Hall, Room 268 F, Buffalo, NY 14214. E-mail: rpd1{at}buffalo.edu

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 100 and 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°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.

Abbreviations: ACR, albumin-to-creatinine ratio • CVD, cardiovascular disease • DPP, Diabetes Prevention Program • eGFR, estimated glomerular filtration rate • GFR, glomerular filtration rate • hs-CRP, high-sensitivity C-reactive protein • IL-6, interleukin-6 • sE-selectin, soluble E-selectin • HOMA-IR, homeostasis model assessment of insulin resistance • IFG, impaired fasting glucose • IGT, impaired glucose tolerance • sICAM-1, soluble intercellular adhesion molecule-1

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				V. Menon, M. J. Sarnak, and M. G. Shlipak Cystatin C, Renal Function, and Cardiovascular Risk Ann Intern Med, February 19, 2008; 148(4): 324 - 324. [Full Text] [PDF]