Chung J O, Cho D H, Chung D J, Chung M Y
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
Exp Clin Endocrinol Diabetes. 2015 Nov;123(10):627-31. doi: 10.1055/s-0035-1555774. Epub 2015 Jul 27.
Previous studies have reported that cystatin C is associated with degenerative disorder in the nervous system. However, the relationship between serum cystatin C concentrations and cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes is currently unknown. The aim of this study was to assess the relationships between serum cystatin C levels and CAN in patients with type 2 diabetes.
A total of 357 patients with type 2 diabetes were studied in this cross-sectional study. CAN was diagnosed by a cardiovascular autonomic reflex test. According to the American Diabetes Association criteria, the degree of cardiovascular autonomic dysfunction was graded as normal, early, definite, or severe. CAN was either definite or severe in the subjects of the present study.
Serum cystatin C concentrations were significantly higher in patients with CAN than in those without CAN. The mean cystatin C levels differed significantly according to the degree of cardiovascular autonomic dysfunction (normal, 0.78 mg/l; early, 0.79 mg/l; definite, 0.87 mg/l; severe, 0.90 mg/l; P for trend=0.021) after adjustment for other covariates. In multivariate analysis, serum cystatin C levels were significantly associated with CAN (odds ratio [OR] of each standard deviation increase in the logarithmic value, 5.25; 95% confidence interval [CI], 1.17-23.70, P=0.025).
Serum cystatin C levels are positively associated with CAN in patients with type 2 diabetes.
既往研究报道胱抑素C与神经系统退行性疾病有关。然而，2型糖尿病患者血清胱抑素C浓度与心血管自主神经病变（CAN）之间的关系目前尚不清楚。本研究旨在评估2型糖尿病患者血清胱抑素C水平与CAN之间的关系。
在这项横断面研究中，共纳入了357例2型糖尿病患者。通过心血管自主神经反射试验诊断CAN。根据美国糖尿病协会标准，将心血管自主神经功能障碍程度分为正常、早期、明确或严重。本研究对象的CAN为明确或严重程度。
CAN患者的血清胱抑素C浓度显著高于无CAN患者。在调整其他协变量后，根据心血管自主神经功能障碍程度，平均胱抑素C水平存在显著差异（正常，0.78mg/l；早期，0.79mg/l；明确，0.87mg/l；严重，0.90mg/l；趋势P=0.021）。在多变量分析中，血清胱抑素C水平与CAN显著相关（对数增加值每增加一个标准差的比值比[OR]为5.25；95%置信区间[CI]为1.17-23.70，P=0.025）。
2型糖尿病患者血清胱抑素C水平与CAN呈正相关。
