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Diabetes Metab J : Diabetes & Metabolism Journal



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2 "Vascular stiffness"
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Cardiovascular Risk/Epidemiology
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The Ratio of Estimated Glomerular Filtration Rate Based on Cystatin C and Creatinine Reflecting Cardiovascular Risk in Diabetic Patients
Ah Reum Khang, Min Jin Lee, Dongwon Yi, Yang Ho Kang
Diabetes Metab J. 2023;47(3):415-425.   Published online March 6, 2023
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  • 118 Download
  • 2 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
The ratio of estimated glomerular filtration rate (eGFR) based on cystatin C and creatinine (eGFRcystatin C/eGFRcreatinine ratio) is related to accumulating atherosclerosis-promoting proteins and increased mortality in several cohorts.
We assessed whether the eGFRcystatin C/eGFRcreatinine ratio is a predictor of arterial stiffness and sub-clinical atherosclerosis in type 2 diabetes mellitus (T2DM) patients, who were followed up during 2008 to 2016. GFR was estimated using an equation based on cystatin C and creatinine.
A total of 860 patients were stratified according to their eGFRcystatin C/eGFRcreatinine ratio (i.e., <0.9, 0.9–1.1 [a reference group], and >1.1). Intima-media thickness was comparable among the groups; however, presence of carotid plaque was frequent in the <0.9 group (<0.9 group, 38.3%; 0.9–1.1 group, 21.6% vs. >1.1 group, 17.2%, P<0.001). Brachial-ankle pulse wave velocity (baPWV) was faster in the <0.9 group (<0.9 group, 1,656.3±333.0 cm/sec; 0.9–1.1 group, 1,550.5±294.8 cm/sec vs. >1.1 group, 1,494.0±252.2 cm/sec, P<0.001). On comparing the <0.9 group with the 0.9–1.1 group, the multivariate-adjusted odds ratios of prevalence of high baPWV and carotid plaque were 2.54 (P=0.007) and 1.95 (P=0.042), respectively. Cox regression analysis demonstrated near or over 3-fold higher risks of the prevalence of high baPWV and carotid plaque in the <0.9 group without chronic kidney disease (CKD).
We concluded that eGFRcystatin C/eGFRcreatinine ratio <0.9 was related to an increased risk of high baPWV and carotid plaque in T2DM patients, especially, those without CKD. Careful monitoring of cardiovascular disease is needed for T2DM patients with low eGFRcystatin C/eGFRcreatinine ratio.


Citations to this article as recorded by  
  • Intraindividual difference in estimated GFR by creatinine and cystatin C, cognitive trajectories and motoric cognitive risk syndrome
    Jinqi Wang, Yueruijing Liu, Rui Jin, Xiaoyu Zhao, Zhiyuan Wu, Ze Han, Zongkai Xu, Xiuhua Guo, Lixin Tao
    Nephrology Dialysis Transplantation.2024; 39(5): 860.     CrossRef
  • Research Progress of Creatinine, Cystatin C, and Their Ratio in Renal Diseases
    广智 杨
    Advances in Clinical Medicine.2024; 14(04): 976.     CrossRef
  • Muscle mass, creatinine, cystatin C and selective glomerular hypofiltration syndromes
    Linnea Malmgren, Anders Grubb
    Clinical Kidney Journal.2023; 16(8): 1206.     CrossRef
  • Investigating kidney function changes in young adults with COVID-19: Serum creatinine level, glomerular filtration rate, and biochemical profile analysis
    Nikita Matyushin, Dmitriy Ermakov, Inna Vasileva, Roza Vakolyuk, Anastasiya Spaska
    Electronic Journal of General Medicine.2023; 20(6): em547.     CrossRef
Arterial Stiffness by Aerobic Exercise Is Related with Aerobic Capacity, Physical Activity Energy Expenditure and Total Fat but not with Insulin Sensitivity in Obese Female Patients with Type 2 Diabetes
Ji Yeon Jung, Kyung Wan Min, Hee Jung Ahn, Hwi Ryun Kwon, Jae Hyuk Lee, Kang Seo Park, Kyung Ah Han
Diabetes Metab J. 2014;38(6):439-448.   Published online December 15, 2014
  • 4,959 View
  • 33 Download
  • 9 Web of Science
  • 6 Crossref
AbstractAbstract PDFPubReader   

Arterial stiffness is an important factor in atherosclerosis. Thus we examined whether aerobic exercise could reduce arterial stiffness in obese women with type 2 diabetes without diabetic complication.


A total of 35 women with type 2 diabetes (body mass index, 26.6±2.8 kg/m2; age, 56.4±1.9 years; duration of diabetes, 4.7±4.8 years) were assigned to aerobic exercise group (AEG) or control group (CG). AEG completed a 12-week exercise program (3.6 to 5.2 metabolic equivalents, 3 day/week, 60 min/day), with their exercise activities monitored by accelerometers. We measured abdominal total fat area (TFA), visceral fat area (VFA), and subcutaneous fat area (SFA) by computed tomography, insulin sensitivity by insulin tolerance test (KITT), and augmentation index (AIx) by SphygmoCor at baseline and at the end of the 12-week program.


The AIx was improved in the AEG compared with the CG (P<0.001). The percent change of AIx had significant correlation with the improvement of physical activity energy expenditure (PAEE), aerobic capacity, TFA, and SFA (r=-0.416, P=0.013; r=0.560, P<0.001; r=0.489, P=0.003; r=0.531, P=0.001, respectively), but not with insulin sensitivity, energy intake, or VFA.


Improvement in aortic stiffness by aerobic exercise is related with the improvement of aerobic capacity, PAEE, and total fat but not with insulin sensitivity or energy intake in obese women with type 2 diabetes.


Citations to this article as recorded by  
  • Relationship between objectively measured physical activity and subclinical cardiovascular disease: a systematic review
    Aparna Narendrula, Ellen Brinza, Christine Horvat Davey, Chris T Longenecker, Allison R Webel
    BMJ Open Sport & Exercise Medicine.2024; 10(1): e001596.     CrossRef
  • Aerobic training reduces pancreatic fat content and improves β‐cell function: A randomized controlled trial using IDEAL‐IQ magnetic resonance imaging
    Min Li, Qidong Zheng, Joshua D. Miller, Panpan Zuo, Xiaodan Yuan, Jitao Feng, Chao Liu, Shan Bao, Qingqing Lou
    Diabetes/Metabolism Research and Reviews.2022;[Epub]     CrossRef
  • Effect of aerobic exercise on waist circumference in adults with overweight or obesity: A systematic review and meta‐analysis
    Alex Armstrong, Klaus Jungbluth Rodriguez, Angelo Sabag, Yorgi Mavros, Helen M. Parker, Shelley E. Keating, Nathan A. Johnson
    Obesity Reviews.2022;[Epub]     CrossRef
  • Aortic waveform responses to insulin in late versus early chronotype with metabolic syndrome
    Mary‐Margaret E. Remchak, Emily M. Heiston, Anna Ballantyne, Brielle L. Dotson, Steven K. Malin
    Physiological Reports.2022;[Epub]     CrossRef
  • Exercise and ectopic fat in type 2 diabetes: A systematic review and meta-analysis
    A. Sabag, K.L. Way, S.E. Keating, R.N. Sultana, H.T. O’Connor, M.K. Baker, V.H. Chuter, J. George, N.A. Johnson
    Diabetes & Metabolism.2017; 43(3): 195.     CrossRef
  • Arterial Stiffness Measured with the Cuff Oscillometric Method Is Predictive of Exercise Capacity in Patients with Cardiac Diseases
    Yasushi Tazawa, Nobuyoshi Mori, Yoshiko Ogawa, Osamu Ito, Masahiro Kohzuki
    The Tohoku Journal of Experimental Medicine.2016; 239(2): 127.     CrossRef

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