Study On The Association Between Cystatin C Levels And Diabetic Retinopathy In Type 2 Diabetes Mellitus Disease

Objective:To research the relationship between serum cystatin C(CysC)levels and the risk of developing diabetic retinopathy(DR)of varying severity in patients with type 2 diabetes mellitus(T2DM).Methods:A cross-sectional analysis was conducted on 1,826 T2DM patients admitted to the Department of Endocrinology,Jining Medical University Hospital between July 1,2017 and November 30,2021.The general clinical information of study subjects was collected through the hospital’s electronic medical record system,including gender,age,drinking history,smoking history,family history of diabetes,chronic diseases history,and diabetes-related complications.Body mass index(BMI)was calculated by measuring weight,waist circumference,and height during a physical examination.The test items are routine blood count,liver function,kidney function,lipid,insulin+c-peptide release test,thyroid function,electrolytes,urine routine,urine microalbumin,fasting blood glucose,glycated hemoglobin.An ophthalmologist examines fundus lesions in all investigators,if necessary,fluorescein fundus angiography was performed.According to the presence or absence of retinopathy,the study population was divided into DR Group and Non-diabetic retinopathy(NDR)group.According to the severity of DR,the study population was divided into Nonproliferative retinopathy(NDR)group.NPDR)group and Proliferative retinopathy(PDR)group.All the data are applied Empower States statistical software for statistical analysis of serum CysC level and DR the risk or severity of correlation.Results:In T2DM patients,the average level of CysC in DR Group(1.02±0.27mg/L)was significantly higher than that in NDR group(0.92±0.20 mg/L)(P<0.05).The results of univariate analysis showed that age,duration of diabetes,hypertension,creatinine,CysC,urinary microalbumin,high-density lipoprotein cholesterol,glycosylated hemoglobin,and diabetic nephropathy were positively correlated with the risk of DR(P<0.05).Male,fatty liver,smoking,hemoglobin,total bilirubin,indirect bilirubin,triglyceride,and LDL were negatively related with the DR risk(P<0.05).Using the smooth curve fitting module,after adjusting for related confounding factors,the follw displayed that there was a linear connection between CysC and the risk of DR In T2DM patients,and the risk of DR Increased significantly with the increase of CysC level.And for every lmg/L increase in CysC level,the risk of DR Increased by 2.32 times(OR=3.32,95%CI:1.66-6.66,P<0.001).In DR Patients,there is a linear relationship between CysC and the risk of NPDR and PDR.With the increase of CysC level,the risk of NPDR and PDR increased significantly.Compared with NDR,the risk of NPDR increased by 2.46 times(OR=3.46,95%CI:1.59-7.56,P<0.001)for every 1mg/L increase in the level of CysC.Compared with NDR,the risk of PDR increased by 3.44 times(OR=4.44,95%CI:1.58-12.49,P=0.005)for every 1mg/L increase in CysC level.There was a linear trend between the quartile of CysC and the risk of DR In T2DM patients.The higher the quartile of CysC,the higher the risk of DR.Conclusions:In patients with T2DM,the level of CysC is positively correlated with the risk of DR And its severity,and the reduction of CysC level is beneficial to reduce the risk of DR And its severity progression.