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ASSOCIATION BETWEEN THE CREATININE-TO-CYSTATIN C RATIO AND RENAL INJURY IN PATIENTS WITH DIABETES MELLITUS
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Abstract
Background: Diabetic kidney disease is one of the most common microvascular complications and a leading cause of end-stage chronic kidney disease in patients with diabetes. Early identification of renal injury is crucial for disease management and prognosis. The creatinine-to-cystatin C ratio (Cre/CysC) has been proposed as an integrated biomarker reflecting both muscle mass and renal function. Objective: To investigate the association between the creatinine-to-cystatin C ratio and renal injury in patients with type 2 diabetes mellitus. Methods: A cross-sectional analytical study was conducted in 124 outpatients with type 2 diabetes mellitus at Military Hospital 175. The Cre/CysC ratio was calculated from serum creatinine and cystatin C concentrations. Renal injury was assessed using the urinary albumin-to-creatinine ratio (ACR, mg/mmol) and estimated glomerular filtration rate (eGFR). The association between Cre/CysC and ACR was evaluated using Spearman correlation and multivariable linear regression analysis. Results: The Cre/CysC ratio showed a strong positive correlation with ACR (r = 0.80; p < 0.05). In multivariable regression analysis, the Cre/CysC ratio remained independently associated with ACR (B = 0.20; standardized β = 0.40; p < 0.05) after adjustment for relevant factors. Diastolic blood pressure was also independently associated with ACR (p < 0.05). Conclusions: The Cre/CysC is strongly associated with albuminuria in patients with type 2 diabetes mellitus and may reflect early renal injury. This simple biomarker may serve as a useful adjunctive tool for early risk assessment of diabetic kidney disease
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Keywords
Type 2 diabetes mellitus, creatinine-to-cystatin C ratio, albuminuria, diabetic kidney disease.
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