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Epidemiology/Health Services/Psychosocial Research

Elevated Cystatin C Concentration and Progression to Pre-Diabetes

The Western New York Study

  1. Richard P. Donahue, PHD1,
  2. Saverio Stranges, MD12,
  3. Karol Rejman, MS1,
  4. Lisa B. Rafalson, MS1,
  5. Jacek Dmochowski, PHD13 and
  6. Maurizio Trevisan, MD, MS1
  1. 1Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, New York
  2. 2Clinical Science Research Institute, Warwick Medical School, Coventry, U.K.
  3. 3Department of Mathematics and Statistics, University of North Carolina Charlotte, Charlotte, North Carolina
  1. Address correspondence and reprint requests to Richard P. Donahue, PhD, MPH, Department of Social and Preventive Medicine, School of Public Health and Health Professions, State University of New York at Buffalo, 3435 Main St., Farber Hall, Room 268 F, Buffalo, NY 14214. E-mail: rpd1{at}buffalo.edu
Diabetes Care 2007 Jul; 30(7): 1724-1729. https://doi.org/10.2337/dc07-0040
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Article Figures & Tables

Tables

  • Table 1—

    Selected baseline characteristics among prediabetic case patients and matched control subjects

    Case patientsControl subjectsP value
    n91273
    Age (years)57.9 ± 11.054.2 ± 10.80.005
    BMI (kg/m2)28.1 ± 5.226.9 ± 4.60.040
    Waist (cm)91.9 ± 13.487.2 ± 12.50.003
    Abdominal height (cm)21.2 ± 3.220.1 ± 3.20.005
    Lifetime total pack-years (cigarettes)14.4 ± 22.69.1 ± 15.80.037
    Physical activity (METs in past 7 days)259.1 ± 46.3262.4 ± 49.80.574
    Glucose (mg/dl)94.2 ± 4.390.4 ± 5.4<0.001
    HOMA3.4 ± 1.72.9 ± 1.50.011
    ACR (mg/g)12.0 ± 37.47.3 ± 10.40.256
    Cystatin C (mg/l)1.0 ± 0.20.9 ± 0.1<0.001
    eGFR (ml/min per 1.73 m2)*83.0 ± 17.785.3 ± 17.00.275
    Serum creatinine (g/l)0.8 ± 0.10.8 ± 0.10.579
    Male sex (%)42.942.9—
    White (%)95.695.6—
    Education >12 years (%)59.371.10.038
    Family history of diabetes (%)42.926.70.005
    Hypertension (%)38.620.80.001
    Family history of hypertension (%)39.335.70.549
    Smoking (%)0.017
        Never37.451.8
        Ever62.648.2
    Drinking (%)0.028
        Abstainer7.79.7
        Non-current30.820.4
        Non-daily50.564.7
        Daily11.05.2
    • Data are means ± SD or n (%).

    • *

      ↵* eGFR = 186 × (serum creatinine−1.154) × (age−0.203) × 1.21 (if black) or × 0.742 (if female).

    • †Matching variable.

  • Table 2—

    Age-adjusted ORs (95% CI) for progression to pre-diabetes according to selected baseline characteristics

    Case patientsControl subjectOR (95% CI)
    BMI (kg/m2)
        <2743 (47.8)161 (60.3)1.00
        ≥2747 (52.2)106 (39.7)1.62 (0.99–2.66)
    Family history of diabetes
        No48 (57.1)189 (73.3)1.00
        Yes36 (42.9)69 (26.7)1.85 (1.12–3.07)*
    Smoking
        Never34 (37.4)141 (51.8)1.00
        Ever57 (62.6)131 (48.2)1.95 (1.15–3.31)*
    Current alcohol drinker
        No35 (38.5)81 (30.1)1.00
        Yes56 (61.5)188 (69.9)0.65 (0.38–1.12)
    Hypertension
        No54 (61.4)213 (79.2)1.00
        Yes34 (38.6)56 (20.8)2.39 (1.35–4.22)†
    Physical activity (total METs in past 7 days)
        < median52 (57.1)136 (50.0)1.00
        ≥ median39 (42.9)136 (50.0)0.82 (0.40–1.37)
    HOMA-IR
        1 (low)15 (17.0)90 (33.2)1.00
        235 (39.8)91 (32.6)2.19 (1.12–4.28)*
        3 (high)38 (42.2)90 (33.2)2.75 (1.37–5.54)†
    ACR (mg/g)
        <2078 (92.9)232 (94.3)1.00
        ≥206 (7.1)14 (5.7)0.94 (0.34–2.60)
    eGFR
        < median52 (57.1)134 (49.1)1.00
        ≥ median39 (42.9)139 (50.9)0.84 (0.50–1.40)
    Serum creatinine (g/l)
        < median39 (42.9)130 (47.6)1.00 (0.66–2.11)
        ≥ median52 (57.1)143 (52.4)1.18
    • Data are n (%) or ORs (95% CI) from conditional logistic regression adjusted for age. Case-patients and control subjects matched on year of baseline interview, sex, race, and year of study enrollment.

    • *

      ↵* P < 0.05;

    • †

      ↵† P < 0.01.

  • Table 3—

    Multivariate ORs (95% CI) for progression to pre-diabetes according to baseline quintile of cystatin C (top 20% vs. lowest 80%)

    Cystatin C (mg/l)Case patientsControl subjectsModel 1Model 2
    Lowest 80%42 (46.7)218 (79.9)1.001.00
    Top 20%48 (53.3)55 (20.1)5.08 (2.69–9.58)*3.28 (1.43–7.54)†
    • Data are n (%) or OR (95% CI) from conditional logistic regression using matched cases and controls. All models are conditioned on sex, race, and year of study enrollment. Model 1 was adjusted for age. Model 2 was adjusted for age, BMI (weight in kilograms divided by the square of height in meters), family history of diabetes (no or yes), current smoker (never or ever), lifetime pack-years, fasting glucose (milligrams per deciliter), current drinker (no or yes), baseline hypertension (no or yes), HOMA-IR, and eGFR.

    • *

      ↵* P < 0.001

    • †

      ↵† P < 0.01.

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Elevated Cystatin C Concentration and Progression to Pre-Diabetes
Richard P. Donahue, Saverio Stranges, Karol Rejman, Lisa B. Rafalson, Jacek Dmochowski, Maurizio Trevisan
Diabetes Care Jul 2007, 30 (7) 1724-1729; DOI: 10.2337/dc07-0040

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Elevated Cystatin C Concentration and Progression to Pre-Diabetes
Richard P. Donahue, Saverio Stranges, Karol Rejman, Lisa B. Rafalson, Jacek Dmochowski, Maurizio Trevisan
Diabetes Care Jul 2007, 30 (7) 1724-1729; DOI: 10.2337/dc07-0040
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