Serum cystatin C and serum creatinine levels in type 2 diabetes mellitus

Ashwin Kumar AS, Anil kumar AS


Background: Diabetes mellitus is a metabolic disorder resulting from deficient insulin secretion, inefficient insulin action or both leading to chronic hyperglycemia. Diabetic complications result from the toxic effects of chronic hyperglycemia combined with other metabolic derangements. Diabetic nephropathy eventually leads to loss of kidney function, which is the most common cause of End stage renal disease. Measurement of GFR is an important parameter in assessing kidney function for which Creatinine is currently being used despite its inherent fallacies. Cystatin C is an alternative marker with some advantages. Aims and objectives: To measure the serum cystatin C levels in type 2 diabetes mellitus patients. To compare serum cystatin C levels with serum creatinine levels in type 2 diabetes mellitus patients.

Methods: The study was carried out in 30 type-2 diabetic patients and 30 non-diabetic controls, in the age group of 35 to 75 years. Both the groups were age and gender matched. Serum cystatin C levels and serum creatinine levels were measured in both the groups. Serum creatinine was estimated by Jaffe's kinetic method, while the estimation of serum cystatin C was done by Immunoturbidimetric method.

Results: Serum creatinine as well as serum cystatin C levels were significantly elevated in the study group as compared to non-diabetic controls. There was a strong positive correlation of serum cystatin C with serum creatinine.

Conclusion: Serum cystatin C can be used as an alternative to serum creatinine in determining GFR in type 2 diabetes mellitus.



Cystatin C, Creatinine, Type 2 diabetes mellitus, Diabetic nephropathy

Full Text:



Salim Bastaki. Diabetes mellitus and its treatment. Int J Diabetes Metabol. 2005;13:111-34.

Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Medical Res. 2007 Mar;125:217-30.

Daniel J. Moore, Justin M. Gregory, Yaa A. Kumah-Crystal, Jill H. Simmons. Mitigating micro- and macro-vascular complications of diabetes beginning in adolescence. Vasc Health Risk Manag. 2009;5:1015-30.

Timothy C. Evans, Peter Capell. Diabetic nephropathy. Clin Diabetes. 2000;18(1):7.

Piero Ruggenenti, Guiseppe Remuzzi. Nephropathy of type 1 and type 2 diabetes: diverse pathophysiology, same treatment? Nephrol Dial Transpalnt. 2000;15:1900-2.

Ayodele OE1, Alebiosu CO, Salako BL. Diabetic nephropathy: a review of natural history, burden, risk factors and treatment. J Natl Med Assoc. 2004;96(11):1445-54.

Christensson AG, Grubb AO, Nilsson JA, Norrgren K, Sterner G, Sundkvist G. Serum cystatin C advantageous compared with serum creatinine in the detection of mild but not severe diabetic nephropathy. J Intern Med. 2004;256:510-8.

Hojs R, Bevc S, Ekart R, Gorenjak M, Puklavec L. Serum cystatin C as an endogenous marker of renal function in patients with mild to moderate impairment of kidney function. Nephrol Dial Transplant. 2006;21:1855-62.

Roos JF, Doust J, Tett SE, Kirkpatrick CM. Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and children: a meta-analysis. Clin Biochem. 2007;40:383-91.

Yun Kyung Jeon, Mi Ra Kim, Jung Eun Huh, Ji Young Mok, Sang Heon Song, Sang Soo Kim, et al. Cystatin C as an early biomarker of nephropathy in patients with type 2 Diabetes. J Korean Med Sci. 2011;26:258-63.

Filler G, Bökenkamp A, Hofmann W, Le Bricon T, Martínez-Brú C, Grubb A. Cystatin C as a marker of GFR: history, indications and future research. Clin Biochem. 2005;38:1-8.

Ronald M. Krauss. Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care. 2004 Jun;27(6):1496-504.

Byron J. Hoogwerf. Complications of diabetes mellitus. Int J Diabetes Devel Countr. 2005;25;63-9.

Richard J. MacIsaac, Erosha Premaratne, George Jerums. Estimating glomerular filtration rate in diabetes using serum cystatin C. Clin Biochem Rev. 2011 May;32:61-7.

Punya Krit Deb Barma, Salam Ranbir, Thangjam Premchand Singh. Clinical and biochemical profile of lean type 2 diabetes mellitus. Indian J Endocrinol Metab. 2011 Jul;15(1):40-3.

Nazmu Saquib, Masuma Akter Khannum, Juliana Saquib, Suchi Anand, Glen M. Chertow. High prevalence of type 2 diabetes among urban middle class in Bangladesh. BMC Public Health. 2013;13:1032.

Borges RL, Hirota AH, Quinto BM, Ribeiro AB, Zanella MT, Batista MC. Is cystatin C a useful marker in the detection of diabetic kidney disease? Nephron Clin Pract. 2010;114(2):127-34.

Bussychaert M, Joudi I, Wallemacq P, Hermans MP. Comparative performance of serum cystatin C versus serum creatinine in diabetic patients. Diabetes Metab. 2003;29:377-83.