Roopa Kanakatti Shankar1, Lawrence M Dolan2, Scott Isom3, Sharon Saydah4, David M Maahs5, Dana Dabelea6, Kristi Reynolds7, Irl B Hirsch8, Beatriz L Rodriguez9, Elizabeth J Mayer-Davis10, Santica Marcovina11, Ralph D'Agostino3, Michael Mauer12, Amy K Mottl13. 1. Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States. Electronic address: roopakshankar@gmail.com. 2. Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States. 3. Department of Biostatistical Sciences, Wake Forest University School of Medicine, NC, United States. 4. Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, United States. 5. Barbara Davis Center for Diabetes, University of Colorado, Denver, CO, United States. 6. Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, CO, United States. 7. Department of Research and Evaluation, Kaiser Permanente South California, Pasadena, CA, United States. 8. Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle, WA, United States. 9. Kuakini Medical Center, HI, United States. 10. Departments of Nutrition and Medicine, University of North Carolina at Chapel Hill, NC, United States. 11. Division of Metabolism, Endocrinology and Nutrition, Northwest Lipid Metabolism and Diabetes Research Laboratories, Seattle, WA, United States. 12. Departments of Pediatrics and Medicine, University of Minnesota, Minneapolis, MN, United States. 13. University of North Carolina Kidney Center, UNC School of Medicine, Chapel Hill, NC, United States.
Abstract
AIMS: We compared cystatin C in youth with versus without diabetes and determined factors associated with cystatin C in youth with type 1 diabetes (T1D) and type 2 diabetes (T2D). METHODS: Youth (ages 12-19years) without diabetes (N=544) were ascertained from the NHANES Study 2000-2002 and those with T1D (N=977) and T2D (N=168) from the SEARCH for Diabetes in Youth Study. Adjusted means of cystatin C concentrations were compared amongst the 3 groups. Next, we performed multivariable analyses within the T1D and T2D SEARCH samples to determine the association between cystatin C and race, sex, age, diabetes duration, HbA1c, fasting glucose, and BMI. RESULTS: Adjusted cystatin C concentrations were statistically higher in NHANES (0.85mg/L) than in either the T1D (0.75mg/L) or T2D (0.70mg/L) SEARCH groups (P<0.0001). Fasting glucose was inversely related to cystatin C only in T1D (P<0.001) and BMI positively associated only in T2D (P<0.01) while HbA1c was inversely associated in both groups. CONCLUSIONS: Cystatin C concentrations are statistically higher in youth without diabetes compared to T1D or T2D, however the clinical relevance of this difference is quite small, especially in T1D. In youth with diabetes, cystatin C varies with BMI and acute and chronic glycemic control, however their effects may be different according to diabetes type.
AIMS: We compared cystatin C in youth with versus without diabetes and determined factors associated with cystatin C in youth with type 1 diabetes (T1D) and type 2 diabetes (T2D). METHODS: Youth (ages 12-19years) without diabetes (N=544) were ascertained from the NHANES Study 2000-2002 and those with T1D (N=977) and T2D (N=168) from the SEARCH for Diabetes in Youth Study. Adjusted means of cystatin C concentrations were compared amongst the 3 groups. Next, we performed multivariable analyses within the T1D and T2D SEARCH samples to determine the association between cystatin C and race, sex, age, diabetes duration, HbA1c, fasting glucose, and BMI. RESULTS: Adjusted cystatin C concentrations were statistically higher in NHANES (0.85mg/L) than in either the T1D (0.75mg/L) or T2D (0.70mg/L) SEARCH groups (P<0.0001). Fasting glucose was inversely related to cystatin C only in T1D (P<0.001) and BMI positively associated only in T2D (P<0.01) while HbA1c was inversely associated in both groups. CONCLUSIONS: Cystatin C concentrations are statistically higher in youth without diabetes compared to T1D or T2D, however the clinical relevance of this difference is quite small, especially in T1D. In youth with diabetes, cystatin C varies with BMI and acute and chronic glycemic control, however their effects may be different according to diabetes type.
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