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Comparison of cystatin C- and creatinine-based estimated glomerular filtration rate to predict coronary heart disease risk in Japanese patients with obesity and diabetes
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- Ito Ryo
- Diabetes Center, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
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- Yamakage Hajime
- Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
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- Kotani Kazuhiko
- Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan Department of Clinical Laboratory Medicine, Jichi Medical University, Shimotsuke 329-0498, Japan
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- Wada Hiromichi
- Division of Translational Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
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- Otani Sumire
- Department of Internal Medicine, Saitama National Hospital, Wako 351-0102, Japan
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- Yonezawa Kazuya
- Department of Clinical Research, Hakodate National Hospital, Hakodate 041-8512, Japan
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- Ogo Atsushi
- Department of Metabolism and Endocrinology, National Hospital Organization Kyushu Medical Center, Fukuoka 810-8563, Japan
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- Okajima Taiichiro
- Department of Internal Medicine and Department of Clinical Research, National Hospital Organization Kokura Medical Center, Kitakyushu 802-8533, Japan
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- Adachi Masahiro
- Department of Internal Medicine and Department of Clinical Research, National Hospital Organization Kokura Medical Center, Kitakyushu 802-8533, Japan
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- Araki Rika
- Department of Internal Medicine, National Mie Hospital, Tsu 514-0125, Japan
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- Yoshida Kazuro
- Department of Cardiology, National Hospital Organization Nagasaki Kawatana Medical Center, Kawatana 859-3615, Japan
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- Saito Miho
- Department of Internal Medicine, Tokushima National Hospital, Yoshinogawa 776-8585, Japan
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- Nagaoka Tadasu
- Department of Internal Medicine, National Hospital Organization Kanazawa Medical Center, Kanazawa 920-8650, Japan
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- Toyonaga Tetsushi
- Department of Diabetes and Endocrinology, National Hospital Organization Kumamoto Medical Center, Kumamoto 860-0008, Japan
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- Tanaka Tsuyoshi
- Department of Endocrinology and Metabolism, National Hospital Organization Mie Chuo Medical Center, Tsu 514-1101, Japan
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- Yamada Tsutomu
- Department of Endocrinology and Diabetes, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan
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- Ota Itsuro
- Department of Internal Medicine, National Hospital Organization Hiroshima-Nishi Medical Center, Otake 739-0696, Japan
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- Oishi Mariko
- Oishi Clinic, Kyoto 612-0875, Japan
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- Miyanaga Fumiko
- Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
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- Shimatsu Akira
- Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
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- Satoh-Asahara Noriko
- Diabetes Center, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
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Description
The aim of this study is to determine which indicator of chronic kidney disease most closely correlates with 10-year Framingham coronary heart disease (CHD) risk among serum creatinine, serum cystatin C (S-CysC), urine albumin-creatinine ratio (UACR), estimated creatinine-based GFRs (eGFRcre), and estimated CysC-based GFRs (eGFRcys) in patients with obesity and diabetes. Serum creatinine, S-CysC, UACR, and cardio-ankle vascular index (CAVI) were examined in 468 outpatients with obesity and type 2 diabetes, free of severe renal dysfunction or previous history of cardiovascular disease, as a cross-sectional survey using baseline data from the multi-centered Japan Diabetes and Obesity Study. S-CysC and eGFRcys had significantly stronger correlations with the 10-year Framingham CHD risk than serum creatinine, eGFRcre, and UACR (creatinine, ρ = 0.318; S-CysC, ρ = 0.497; UACR, ρ = 0.174; eGFRcre, ρ = -0.291; eGFRcys, ρ = -0.521; P < 0.01 by Fisher’s z-test). S-CysC and eGFRcys had significantly stronger correlations with CAVI than serum creatinine, eGFRcre, and UACR (creatinine, ρ = 0.198; S-CysC, ρ = 0.383; UACR, ρ = 0.183; eGFRcre, ρ = -0.302; eGFRcys, ρ = -0.444; P < 0.05 by Fisher’s z-test). The receiver operating characteristic curves to distinguish the high-risk patients for CHD revealed significantly larger areas under the curve of S-CysC and eGFRcys than those of serum creatinine, UACR, and eGFRcre (serum creatinine, 0.64; S-CysC, 0.75; UACR, 0.56; eGFRcre, 0.63; eGFRcys, 0.76; P < 0.01). The data suggested that eGFRcys can be more predictive of the 10-year CHD risk than eGFRcre in Japanese patients with obesity and diabetes.
Journal
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- Endocrine Journal
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Endocrine Journal 62 (2), 201-207, 2015
The Japan Endocrine Society