Comparison of serum and urinary cystatin-c in in children with type one diabetes mellitus and controls

Aim of study: cystatin- c is recently introduced for estimation of GFR in diabetic patients. Metabolism and factors impacting serum and urinary levels of cystatin- c is less studied, especially in children. Here we compared serum and urinary level of cystatin-c in in children with type one diabetes mellitus and controls to answer the question that is cystatin-c production and elimination is altered in diabetes mellitus Method:patients with stable T1D and healthy controls aged 2–18 years with no history of recent infection were included. Written informed Consents were taken from the parents before enrollment. Cystatin-c were determined in fasting plasma sample and 24 hours urine. Other variables were age, gender, weight and height percentile, body mass index, thyroid status, blood pressure, HbA1C, serum creatinine, 24 hours urine albumin and GFR. Comparisonswere performed using appropriate statistical approach Results: plasma cystatin-c had normal distribution. Mean and standard deviation of plasma cystatin-c in diabetic and normal subjects were 869(358) and 937(183) microgram in liter, respectively. There was no significant difference among plasma level of cystatin-c between diabetic and normal subjects or diabetic with and without albuminuria. Urine cystatin-c was not normally distributed. Median and range of urinary cystatin-c were 32(999) for diabetic patients without proteinuria, 23(3292) for diabetic patients with proteinuria and 39(297) for normal subjects. Urinary creatinine had no significant differenceamong tree groups. Urinary volume, as expected, was higher in diabetic patients, both without and with albuminuria, than normal ones. Diabetic patients had higher plasma creatinine than normal subjects. GFR had no significant among tree groups.Conclusion: despite similar plasma levels of cystatin-c, diabetic patients with albuminuria have more variations in urinary elimination of cystatin-c. cystatin-c seems to differentiate the renal failure before decrease of GFR.

کلیدواژه ها:

cystatin-c ، children ، type one diabetes mellitus