Serum cystatin C levels are associated with asymptomatic peripheral arterial disease in type 2 diabetes mellitus patients without overt nephropathy

Diabetes Res Clin Pract. 2015 May;108(2):258-64. doi: 10.1016/j.diabres.2015.02.006. Epub 2015 Feb 16.


Aims: We investigated the association between serum cystatin C and asymptomatic peripheral artery disease (PAD) in type 2 diabetes mellitus patients with normal renal function or mild renal impairment and we compared cystatin C with albuminuria and estimated glomerular filtration rate (eGFR) for prediction of PAD.

Methods: We enrolled 272 patients with type 2 diabetes. Patients were excluded if they had an eGFR<60mL/min per 1.73m(2), 24-h urine albumin (24h-uAlb)≥300mg/day, serum creatinine (Cr)>1.3mg/dL, or previous history of cardiovascular disease. PAD was defined as having an ankle brachial index (ABI)≤0.9.

Results: Patients with PAD were more likely to have a lower eGFR and higher values of 24h-uAlb, cystatin C, and serum Cr than subjects without PAD. Cystatin C was independently associated with age, current smoking, HDL, eGFR, and PAD. Odds ratios (ORs) for PAD after adjustment for age, gender, smoking, and hypertension were 1.71 (95% CI, 1.02-2.85), 1.51 (95% CI, 0.93-2.44), and 0.78 (95% CI, 0.41-1.49) for a one standard deviation increase in cystatin C, 24h-uAlb, and eGFR, respectively.

Conclusions: Cystatin C was independently associated with PAD in type 2 diabetes mellitus patients without overt nephropathy.

Keywords: Cystatin C; Peripheral arterial disease; Renal impairment; Type 2 diabetes.

MeSH terms

  • Aged
  • Albuminuria / blood
  • Albuminuria / epidemiology
  • Albuminuria / etiology
  • Ankle Brachial Index
  • Asymptomatic Diseases*
  • Cystatin C / blood*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Angiopathies / blood*
  • Diabetic Angiopathies / diagnosis
  • Diabetic Nephropathies / blood
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / blood*
  • Peripheral Arterial Disease / etiology


  • Cystatin C