Original Article

J Korean Soc Pediatr Endocrinol. 2008; 13(2): 177-183.

Effectiveness of Serum Cystatin C and beta2-microglobulin as early Predictive Markers of Diabetic Nephropathy.

Hyun Wook Chae, Jae Il Shin, Beom Seok Kim, Ho Seong Kim, and Duk Hee Kim

¹Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. dhkim3@yuhs.ac
²Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

PURPOSE
Early detection of diabetic nephropathy is very important for prevention of renal failure. Determination of microalbuminuria has been suggested as an early predictor of diabetic nephropathy, but it is tend to be erroneous and inaccurate, especially in childhood. The aim of this study is to show clinical values of serum cystatin C and beta(2)-microglobulin in the assessment of renal function in diabetic children and adolescents. METHODS: Ninety four type 1 and 2 diabetic patients with normoalbuminuria (n=78), microalbuminuria (n= 15) and macroalbuminuria (n=1) were enrolled. Serum concentration of cystatin C, beta2-microglobulin, creatinine, urinary microalbumin levels and creatinine clearances were determined.
RESULTS
In patients with microalbuminuria, serum concentration of cystatin C was increased significantly in comparison to patients with normoalbuminuria (P<0.05), while no differences were observed for beta2- microglobulin levels. Serum creatinine concentrations were not different between both groups. Serum concentration of cystatin C was positively correlated with serum beta2-microglobulin and serum creatinine. The serum concentration of beta2-microglobulin was not correlated with the decrease of renal function significantly.
CONCLUSION
Serum cystatin C is a useful endogenous marker in assessment of renal function in pediatric diabetic patients.

Keywords : Diabetic nephropathy, Cystatin C, beta2-microglobulin, Creatinine