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

Figures & data

Table 1. Formulas for estimating glomerular filtration rate.

	Gender	Creatinine (mg/dL)	cystatin C (mg/L)	Formula
CKD-EPI eGFRcreatinine	female	≤0.7		144×(sCr/0.7)^–0.329×0.993^age
	female	>0.7		144×(sCr/0.7)^–1.209×0.993^age
	male	≤0.9		144×(sCr/0.7)^–0.411×0.993^age
	male	>0.9		144×(sCr/0.7)^–1.209×0.993^age
CKD-EPI eGFRcystatin C	female		≤0.8	133×(cystatin C/0.8)^-0.499×0.996^age×0.932
	female		>0.8	133×(cystatin C/0.8)^-1.328×0.996^age×0.932
	male		≤0.8	133×(cystatin C/0.8)^-0.499×0.996^age
	male		>0.8	133×(cystatin C/0.8)^-1.328×0.996^age

Table 2. Baseline characteristics of patients with type 2 diabetes.

Variables	Total (n = 270)	Group A (n = 89)	Group B (n = 181)	P-value
Male (n, %)	164 (60.7%)	59 (66.3%)	105 (58.0%)	0.19
Age (years)	54 (44, 62)	58 (47, 64)	51 (42, 59)	<0.01
Hypertension (n, %)	120 (44.4%)	51 (57.3%)	69 (38.1%)	<0.01
Smoking habit (n, %)	62 (23%)	24 (27.0%)	38 (21.0%)	0.27
Drinking habit (n, %)	37 (13.7%)	13 (14.6%)	24 (13.3%)	0.76
Diabetes family history (n, %)	90 (33.3%)	24 (27.0%)	66 (36.5%)	0.12
CVD family history (n, %)	18 (6.7%)	9 (10.1%)	9 (5.0%)	0.11
BMI (kg/m^2)	24.46 (22.59, 26.81)	25.39 (23.11, 27.43)	24.11 (22.45, 26.50)	<0.01
SBP (mmHg)	137.76 ± 15.42	139.69 ± 16.53	136.90 ± 14.68	0.16
DBP (mmHg)	85 (79, 91)	85 (80, 93)	84 (78, 91)	0.20
Albumin (g/L)	37.90 ± 3.35	37.55 ± 3.08	38.11 ± 3.46	0.20
Globulin (g/L)	26.40 (23.20, 28.86)	26.00 (23.18, 28.80)	26.55 (23.40, 28.90)	0.54
FPG (mmol/L)	8.99 (7.13, 11.36)	8.38 (6.95, 11.14)	9.32 (7.42, 11.49)	0.09
BUN (mmol/L)	4.80 (3.95, 5.75)	4.82 (4.15, 5.59)	4.85 (3.87, 5.81)	0.99
Serum creatinine (μmol/L)	77.60 (67.38, 87.20)	76.30 (64.55, 87.45)	78.00 (67.30, 87.15)	0.43
Cystatin C (mg/L)	0.95 (0.80, 1.08)	1.11 (1.01, 1.30)	0.85 (0.72, 0.98)	<0.01
eGFRcystatin C (ml/min/1.73m^2)	86.35 ± 22.96	66.12 ± 15.41	96.54 ± 19.74	<0.01
eGFRcreatinine (ml/min/1.73m^2)	89.35 ± 16.98	90.29 ± 18.96	89.58 ± 16.82	0.75
eGFRcystatin C/eGFRcreatinine	0.97 (0.80, 1.12)	0.76 (0.67, 0.80)	1.05 (0.97, 1.17)	<0.01
Uric acid (μmol/L)	256.95 (205.35, 309.18)	285.20 (218.20, 338.50)	242.70 (199.85, 296.30)	<0.01
CRP (mg/L)	3.70 (3.20, 4.10)	3.70 (3.10, 4.05)	3.7 (3.20, 4.20)	0.63
Cholesterol (mmol/L)	4.99 (4.35, 5.57)	4.98 (4.20, 5.60)	4.86 (3.29, 5.57)	0.68
Triglyceride (mmol/L)	2.35 (1.60, 3.58)	2.67 (1.67, 4.56)	2.29 (1.57, 3.12)	0.03
HDL-C (mmol/L)	1.05 (0.88, 1.19)	1.03 (0.88, 1.16)	1.04 (0.87, 1.20)	0.43
LDL-C (mmol/L)	2.49 (2.08, 2.93)	2.52 (2.06, 2.83)	2.44 (2.07, 2.93)	0.73
apo-A1 (g/L)	1.21 ± 0.15	1.21 ± 0.14	1.20 ± 0.15	0.42
apo-B (g/L)	1.02 (0.87, 1.22)	1.06 (0.89, 1.30)	1.00 (0.84, 1.17)	0.06
HbA1c (%)	10.6 (8.5, 12.1)	10.5 (8.4, 11.9)	10.9 (8.5, 12.2)	0.46
FRS				0.03
Low risk (n, %)	163 (60.4%)	44 (49.4%)	119 (65.7%)
Intermediate risk (n, %)	79 (29.3%)	32 (36.0%)	47 (26.0%)
High risk (n, %)	28 (10.4%)	13 (14.6%)	15 (8.3%)

Figure 1. The association between FRS and eGFR_{cystatin C}/eGFR_creatinine ratio at 4 ranges in univariate analysis.

Table 3. Association between baseline characteristics of T2DM and Framingham risk score (univariate Ordinal logistic regression analysis).

Variables	FRS
	Univariate analysis
	OR (95% CI)	P-value
Gender (male vs. female)	10.48 (5.36, 20.49)	<0.01
Age (years)	1.11 (1.08, 1.14)	<0.01
Hypertension	2.86 (1.75, 4.67)	<0.01
Smoking habit	6.41 (3.60, 11.44)	<0.01
Drinking habit	2.57 (1.33, 4.98)	<0.01
Diabetes family history	0.74 (0.44, 1.23)	0.24
CVD family history	0.45 (0.15, 1.37)	0.16
BMI (kg/m^2)	0.98 (0.91, 1.05)	0.55
SBP (mmHg)	1.02 (1.01, 1.04)	<0.01
DBP (mmHg)	0.99 (0.97, 1.02)	0.60
Albumin (g/L)	0.95 (0.88, 1.02)	0.15
Globulin (g/L)	0.97 (0.92, 1.03)	0.29
FPG (mmol/L)	1.02 (0.95, 1.10)	0.52
BUN (mmol/L)	1.50 (1.23, 1.83)	<0.01
Serum creatinine (μmol/L)	1.04 (1.02, 1.06)	<0.01
Cystatin C (mg/L)	13.77 (4.71, 40.28)	<0.01
eGFRcystatin C (ml/min/1.73m^2)	0.97 (0.96, 0.98)	<0.01
eGFRcreatinine (ml/min/1.73m^2)	0.97 (0.96, 0.98)	<0.01
eGFRcystatin C/eGFRcreatinine (per 0.1unit)	0.86 (0.77, 0.97)	0.01
Shrunken pore syndrome	1.99 (0.94, 4.23)	0.07
eGFRcystatin C/eGFRcreatinine (≤0.85 vs. >0.85)	1.95 (1.18, 3.21)	<0.01
Uric acid (μmol/L)	1.00 (1.00, 1.00)	0.76
CRP (mg/L)	0.89 (0.77, 1.03)	0.12
Cholesterol (mmol/L)	1.27 (1.06, 1.53)	0.01
Triglyceride (mmol/L)	1.06 (0.96, 1.16)	0.24
HDL-C (mmol/L)	0.26 (0.09, 0.79)	0.02
LDL-C (mmol/L)	1.60 (1.14, 2.25)	<0.01
apo-A1 (g/L)	1.15 (0.23, 5.73)	0.87
apo-B (g/L)	1.74 (1.00, 3.05)	0.05
HbA1c (%)	1.12 (1.01, 1.24)	0.03

Table 4. Association between continuous eGFR_{cystatin C}/eGFR_creatinine and Framingham risk score (multivariate Ordinal logistic regression analysis).

Variables	FRS
	Multivariate analysis
	OR (95% CI)	P-value
Hypertension	3.23 (1.89, 5.52)	<0.01
Drinking habit	3.24 (1.60, 6.59)	<0.01
LDL-C (mmol/L)	1.74 (1.20, 2.51)	<0.01
HbA1c (%)	1.12 (1.01, 1.26)	0.04
BUN (mmol/L)	1.54 (1.24, 1.90)	<0.01
eGFRcystatin C/eGFRcreatinine (per 0.1unit)	0.87 (0.77, 0.99)	0.03

Table 5. Association between eGFR_{cystatin C}/eGFR_creatinine≤0.85 and Framingham risk score (multivariate Ordinal logistic regression analysis).

Variables	FRS
	Multivariate analysis
	OR (95% CI)	P-value
Hypertension	3.18 (1.86, 5.44)	<0.01
Drinking habit	3.31 (1.63, 6.73)	<0.01
LDL-C (mmol/L)	1.72 (1.19, 2.48)	<0.01
HbA1c (%)	1.13 (1.01, 1.26)	0.04
BUN (mmol/L)	1.52 (1.23, 1.87)	<0.01
eGFRcystatin C/eGFRcreatinine (≤0.85 vs. >0.85)	1.86 (1.08, 3.21)	0.03

Availability of data and materials

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