A lower eGFR_{cystatin C}/eGFR_creatinine ratio is associated with greater cardiovascular risk (higher Framingham Risk Score) in Chinese patients with newly diagnosed type 2 diabetes mellitus

Abstract

Background

Cardiovascular disease (CVD) is the leading cause of mortality in type 2 diabetes mellitus (T2DM) patients. Shrunken pore syndrome (SPS) is defined as eGFR_{cystatin C}/eGFR_creatinine ratio <0.70 and predicts high CVD mortality. The Framingham Risk Score (FRS) is used to estimate an individual’s 10-year CVD risk. This study investigated the association between FRS and eGFR_{cystatin C}/eGFR_creatinine ratio in T2DM patients.

Methods

Patients aged 18-80 years who were newly diagnosed with T2DM were included in this retrospective study. Ordinal logistic regression analysis was used to investigate the association between risk factors of T2DM and FRS. A Generalized Linear Model was used to calculate odds ratios (OR) and 95% confidence intervals (CI).

Results

There were 270 patients included in the study. Only 27 patients (10%) met the diagnostic criteria of SPS. Ordinal logistic regression analysis showed that SPS was not correlated with FRS risk (OR = 1.99, 95%CI = 0.94–4.23, p = 0.07), whereas eGFR_{cystatin C}/eGFR_creatinine (OR = 0.86, 95%CI = 0.77–0.97, p = 0.01) showed a significant negative association with FRS risk. Compared with eGFR_{cystatin C}/eGFR_creatinine>0.85, eGFR_{cystatin C}/eGFR_creatinine≤0.85 increased FRS risk (OR = 1.95, 95%CI = 1.18–3.21, p < 0.01). After adjustment for confounding factors, increased eGFR_{cystatin C}/eGFR_creatinine ratio was associated with decreased FRS risk when considered as a continuous variable (OR = 0.87, 95%CI = 0.77–0.99, p = 0.03). The FRS risk in patients with eGFR_{cystatin C}/eGFR_creatinine≤0.85 is 1.86 times higher than that in patients with eGFR_{cystatin C}/eGFR_creatinine>0.85 (OR = 1.86, 95%CI = 1.08–3.21, p = 0.03).

Conclusions

In the current study, no significant association between SPS and FRS was identified. However, lower eGFR_{cystatin C}/eGFR_creatinine and eGFR_{cystatin C}/eGFR_creatinine≤0.85 were associated with a significantly increased CVD risk in T2DM.

Keywords:

• Type 2 diabetes mellitus
• framingham risk score
• shrunken pore syndrome
• eGFR

Declarations

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Third Affiliated Hospital of Soochow University, China (registration number:27/2013), and conformed to the principles of the Declaration of Helsinki. Written informed consent was obtained from all the patients.

Acknowledgements

Not applicable.

Authors’ contributions

Yan Yang: Methodology, Formal Analysis, Writing-Original Draft Preparation, Funding Acquisition; Bixia Yang: Resources, Data Curation, Formal Analysis, Investigation; Shizhu Zhao: Resources, Data Curation, Writing–Review & Editing; Shusu Liu: Software, Investigation, Data Curation; Hua Zhou: Validation, Visualization; Min Yang: Conceptualization, Funding Acquisition, Project Administration; Ning Xu: Conceptualization, Supervision.

Consent for publication

Not applicable.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data and materials

Data used to support the findings of this study are available from the corresponding author upon request.

Additional information

Funding

This study was supported by the Changzhou Science and Technology Youth Talent Support Program (Grant No. KY20221408), Funding from Young Talent Development Plan of Changzhou Health Commission (Grant No. CZQM2023002) and Changzhou Key Medical Discipline (Grant No. CZXK202204).