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Elevated cystatin C concentration and progression to pre-diabetes: the Western New York study.

Abstract：

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 > or = 100 and < or = 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 degrees 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.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Donahue RP,Stranges S,Rejman K,Rafalson LB,Dmochowski J,Trevisan M

doi

10.2337/dc07-0040

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

1724-9

issue

eissn

0149-5992

issn

1935-5548

pii

dc07-0040

journal_volume

pub_type

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Elevated cystatin C concentration and progression to pre-diabetes: the Western New York study.