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

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 1.73m², 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 24. h-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, 24. h-uAlb, and eGFR, respectively. Conclusions: Cystatin C was independently associated with PAD in type 2 diabetes mellitus patients without overt nephropathy.