Comparison of cystatin C- and creatinine-based estimated glomerular filtration rate to predict coronary heart disease risk in Japanese patients with obesity and diabetes

Ryo Ito; Hajime Yamakage; Kazuhiko Kotani; Hiromichi Wada; Sumire Otani; Kazuya Yonezawa; Atsushi Ogo; Taiichiro Okajima; Masahiro Adachi; Rika Araki; Kazuro Yoshida; Miho Saito; Tadasu Nagaoka; Tetsushi Toyonaga; Tsuyoshi Tanaka; Tsutomu Yamada; Itsuro Ota; Mariko Oishi; Fumiko Miyanaga; Akira Shimatsu; Noriko Satoh-Asahara

doi:10.1507/endocrj.EJ14-0352

ORIGINALS

Comparison of cystatin C- and creatinine-based estimated glomerular filtration rate to predict coronary heart disease risk in Japanese patients with obesity and diabetes

Ryo Ito, Hajime Yamakage, Kazuhiko Kotani, Hiromichi Wada, Sumire Otani, Kazuya Yonezawa, Atsushi Ogo, Taiichiro Okajima, Masahiro Adachi, Rika Araki, Kazuro Yoshida, Miho Saito, Tadasu Nagaoka, Tetsushi Toyonaga, Tsuyoshi Tanaka, Tsutomu Yamada, Itsuro Ota, Mariko Oishi, Fumiko Miyanaga, Akira Shimatsu, Noriko Satoh-Asahara

Author information

Ryo Ito
Diabetes Center, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
Hajime Yamakage
Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
Kazuhiko Kotani
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
Hiromichi Wada
Division of Translational Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
Sumire Otani
Department of Internal Medicine, Saitama National Hospital, Wako 351-0102, Japan
Kazuya Yonezawa
Department of Clinical Research, Hakodate National Hospital, Hakodate 041-8512, Japan
Atsushi Ogo
Department of Metabolism and Endocrinology, National Hospital Organization Kyushu Medical Center, Fukuoka 810-8563, Japan
Taiichiro Okajima
Department of Internal Medicine and Department of Clinical Research, National Hospital Organization Kokura Medical Center, Kitakyushu 802-8533, Japan
Masahiro Adachi
Department of Internal Medicine and Department of Clinical Research, National Hospital Organization Kokura Medical Center, Kitakyushu 802-8533, Japan
Rika Araki
Department of Internal Medicine, National Mie Hospital, Tsu 514-0125, Japan
Kazuro Yoshida
Department of Cardiology, National Hospital Organization Nagasaki Kawatana Medical Center, Kawatana 859-3615, Japan
Miho Saito
Department of Internal Medicine, Tokushima National Hospital, Yoshinogawa 776-8585, Japan
Tadasu Nagaoka
Department of Internal Medicine, National Hospital Organization Kanazawa Medical Center, Kanazawa 920-8650, Japan
Tetsushi Toyonaga
Department of Diabetes and Endocrinology, National Hospital Organization Kumamoto Medical Center, Kumamoto 860-0008, Japan
Tsuyoshi Tanaka
Department of Endocrinology and Metabolism, National Hospital Organization Mie Chuo Medical Center, Tsu 514-1101, Japan
Tsutomu Yamada
Department of Endocrinology and Diabetes, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan
Itsuro Ota
Department of Internal Medicine, National Hospital Organization Hiroshima-Nishi Medical Center, Otake 739-0696, Japan
Mariko Oishi
Oishi Clinic, Kyoto 612-0875, Japan
Fumiko Miyanaga
Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
Akira Shimatsu
Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
Noriko Satoh-Asahara
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

Keywords: Cystatin C, eGFR, CKD, Framingham score, Cardio-renal association

JOURNAL FREE ACCESS

2015 Volume 62 Issue 2 Pages 201-207

DOI https://doi.org/10.1507/endocrj.EJ14-0352

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Abstract

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.

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