Research Article
Volume 4 Issue 3 - 2020
Serum Cystatin C in Early Kidney Dysfunction in Prediabetic Participants of the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil
Julia Ines F Branda1,4, Bianca de Almeida-Pititto2,4, Isabela Bensenor3,4, Paulo A Lotufo3,4 and Sandra Roberta G Ferreira1,4*
1Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
2Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil
3Department of Internal Medicine, Medical School, University of São Paulo, Brazil
4Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil
*Corresponding Author: Sandra Roberta G Ferreira, Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
Received: January 23, 2020; Published: February 08, 2020




Abstract

Serum cystatin C (sCys C) was proposed as a marker of kidney function. In diabetic subjects, slight elevation of albuminuria indicates renal damage but it is unclear whether this begins in prediabetic stages. We investigated whether sCys C levels are already increased in prediabetes, contributing to early detection of kidney dysfunction. In a cross-sectional analysis of 947 participants of the Brazilian Longitudinal Study of Adult Health - ELSA, sCys C and estimated glomerular filtration rate (eGFR) were compared between normoglycemic and prediabetic subjects. Prediabetic subjects were stratified into 4 groups - G1, normal sCys C and normal albumin-to-creatinine ratio (ACR); G2, abnormal sCys C and normal ACR; G3, normal sCys C and abnormal ACR; G4, abnormal sCys C and ACR, and their eGFR compared. Prediabetic subjects had higher sCys C than normoglycemic ones [0.67 (0.41 - 0.95) vs 0.48 (0.31 - 0.81) mg/L, p < 0.001] and lower eGFR (96.3 ± 17.4 vs 100.6 ± 17.1 mL/min/1.73m2, p < 0.001). Normoglycemic hyperfiltrating subjects had lower sCys C than normofiltrating ones (p = 0.035). Considering prediabetic groups, eGFR gradually decreased from G1 to G4 (96.8 ± 17.4 vs 96.2 ± 16.9 vs 94.0 ± 17.2 vs 77.2 ± 25.4 mL/min/1.73m2, p-trend = 0.06) and mean eGFR in G4 was lower than in G1 (p = 0.017). The finding of higher sCys C levels in prediabetic subjects suggests this determination could be a helpful marker for examining kidney function in early stages of dysglycemia when albuminuria is still within the normal range. The follow-up of participants should allow testing the role of sCys C as an early marker for renal dysfunction in prediabetes.

Keywords: Prediabetes; Kidney Disease; Glomerular Filtration Rate; Cystatin C; Microalbuminuria

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Citation: Julia Ines F Branda., et al. “Serum Cystatin C in Early Kidney Dysfunction in Prediabetic Participants of the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil”. EC Nutrition 4.3 (2020): 01-11.

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