Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2

Brown Holy; Joshua Marcella Tari

doi:doi:10.11648/j.ejpm.20160403.15

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Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2

Brown Holy, Joshua Marcella Tari

Published in European Journal of Preventive Medicine (Volume 4, Issue 3)

Received: 7 April 2016 Accepted: 19 April 2016 Published: 3 May 2016

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Abstract

Diabetes mellitus (DM) is characterized by hyperglycaemia and glycosuria due to defects in insulin secretion from the Islets of Langerhans and associated with cardiovascular disease (CVD). The imperativeness to assess effectiveness of various cardiovascular risk tools is critical with increasing rate of people with diabetes type 2. Study was aimed at the assessment and evaluation of the diagnostic relevance of homocysteine, Cystatin C, cardiovascular risk indices in the risk profile of cardiovascular diseases in Type 2 diabetes mellitus patients. A total of 165 patients were involved in the study, of which 100 were diabetic (test) and 65 non-diabetics (control). The diabetic subjects were those whose glycated haemoglobin (HbA1C) levels were ≥ 6.5%. HbA1C was estimated quantitatively by immunochemical method, Homocysteine (Hcy), Cystatin C, Lipoprotein (a) (Lp (a) were measured by Enzyme Linked Immunosorbent assay (ELISA) method; Glucose oxidase method was used for the determination of fasting plasma glucose (FBS). The results showed elevated serum homocysteine (Hcy), Lp (a) among the diabetics as compared to the non-diabetic subjects (p<0.05). The diabetic subjects also depicted higher Cystatin C (Cys C) levels, in the diabetic type 2 patients compared to the non-diabetic patients. The lipid profile levels in the diabetic subjects showed higher mean values of total cholesterol and triglycerides, (p < 0.05) as compared with the non-diabetic. The percentage risk predictive values of cardiovascular disease in the diabetic sub-population with these risk indices showed Hcy with a sensitivity of 96%, specificity of 96.9% and an accuracy of 96.5% as compared to Cys C with a sensitivity of 95%, specificity of 96.9%, accuracy of 95.9% also compared with that of Lp (a) with a sensitivity of 91%, specificity of 100% and an accuracy of 95.5%. The level of accuracy of Hcy, Cys C and then Lp (a) amongst other indices showed that these diagnostic tools could provide better platform in cardiovascular risk profiling of T2DM patients and should be encouraged.

Published in	European Journal of Preventive Medicine (Volume 4, Issue 3)
DOI	10.11648/j.ejpm.20160403.15
Page(s)	79-84
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diabetes, Cardiovascular, Risk, Cystatin C, Homocysteine, Lipids

References

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[6]	Clarke, R., Peden, J. F, Hopewell, J. C. (2013). PROCADIS consortium, Genetic variants associated with Lp (a) Lipoprotein a, levels and coronary disease. Journal of New England of Medicine, 361 (26), 2518-2528
[7]	Wild, S., Roglic, G., Green, A., Sicee, R. & King, H. (2004). Global prevalence of diabetes. Estimates for the year 2000 and projections for 2030. Journal of Diabetic Care,. 27,1047–1053
[8]	Gregg E. W., Cheng Y. J., Cadwell B. L., Imperatore G, William D. E., Flegal, K. M., Narayan & K. M., Williamson, D. F (2005). Secular trends in cardiovascular disease risk factors according to body mass index in US adults. Journal of American Medical Association, 293, 1868-1874
[9]	Yun K. J., Mi R. K., Jung E. H., Ji Y. M., Sang H. S., Sang S. K., Bo H. K., Soo H. L., Yong K. K. & In J. K. (2011). Cystatin C as an Early Biomarker of Nephropathy in Patients with Type 2 Diabetes, Endocrinology, Nutrition & Metabolism, Journal of Korean Medical Science, 26, 258-263
[10]	Pucci, L., Triscornia, S., Lucchesi, D. (2007). Cystatin C and estimates of renal function: searching for a better measure of kidney function in diabetic patients. Journal of Clinical Chemistry, 53, 480-488
[11]	National Kidney Foundation (2002). Clinical practice guideline to define chronic kidney disease evaluation, classification and stratification. American Journal of kidney
[12]	American Diabetes Association (2003). Management of dyslipidemia in adults with diabetes mellitus type 2 (position statement). Journal of Diabetes Care, S83-S86
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[14]	Hojs, R., Bevc, R., Ekart, M., Gorenjak, Puklaverc, L. (2008). Serum cystatin C – based equation compared to serum creatinine-based equations for estimation of glomerular filtration rate in patients with chronic kidney disease. Journal of Clinical Nephrology, 70, 10-17
[15]	Clark, R., Halsey, J., Lewington, S., Lonn, E., Armitage, J., Manson, J. E., Bonna, K. H., Spence, J. D., (2012). Effect of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer and cause specific mortality, and meta-analysis of 8 randomized trials involving 37, 485 individuals. Arch International Medicine 170, 1672-1631
[16]	Wang, S. R., Ynz, H. C., Messias, A. C. & Floegel, A. H., (2012). Novel biomarkers for pre-diabetics identified by metabolomics. Molecular System Biology,. 8, 615
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APA Style

Brown Holy, Joshua Marcella Tari. (2016). Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2. European Journal of Preventive Medicine, 4(3), 79-84. https://doi.org/10.11648/j.ejpm.20160403.15

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ACS Style

Brown Holy; Joshua Marcella Tari. Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2. Eur. J. Prev. Med. 2016, 4(3), 79-84. doi: 10.11648/j.ejpm.20160403.15

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AMA Style

Brown Holy, Joshua Marcella Tari. Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2. Eur J Prev Med. 2016;4(3):79-84. doi: 10.11648/j.ejpm.20160403.15

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@article{10.11648/j.ejpm.20160403.15,
  author = {Brown Holy and Joshua Marcella Tari},
  title = {Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2},
  journal = {European Journal of Preventive Medicine},
  volume = {4},
  number = {3},
  pages = {79-84},
  doi = {10.11648/j.ejpm.20160403.15},
  url = {https://doi.org/10.11648/j.ejpm.20160403.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejpm.20160403.15},
  abstract = {Diabetes mellitus (DM) is characterized by hyperglycaemia and glycosuria due to defects in insulin secretion from the Islets of Langerhans and associated with cardiovascular disease (CVD). The imperativeness to assess effectiveness of various cardiovascular risk tools is critical with increasing rate of people with diabetes type 2. Study was aimed at the assessment and evaluation of the diagnostic relevance of homocysteine, Cystatin C, cardiovascular risk indices in the risk profile of cardiovascular diseases in Type 2 diabetes mellitus patients. A total of 165 patients were involved in the study, of which 100 were diabetic (test) and 65 non-diabetics (control). The diabetic subjects were those whose glycated haemoglobin (HbA1C) levels were ≥ 6.5%. HbA1C was estimated quantitatively by immunochemical method, Homocysteine (Hcy), Cystatin C, Lipoprotein (a) (Lp (a) were measured by Enzyme Linked Immunosorbent assay (ELISA) method; Glucose oxidase method was used for the determination of fasting plasma glucose (FBS). The results showed elevated serum homocysteine (Hcy), Lp (a) among the diabetics as compared to the non-diabetic subjects (p<0.05). The diabetic subjects also depicted higher Cystatin C (Cys C) levels, in the diabetic type 2 patients compared to the non-diabetic patients. The lipid profile levels in the diabetic subjects showed higher mean values of total cholesterol and triglycerides, (p < 0.05) as compared with the non-diabetic. The percentage risk predictive values of cardiovascular disease in the diabetic sub-population with these risk indices showed Hcy with a sensitivity of 96%, specificity of 96.9% and an accuracy of 96.5% as compared to Cys C with a sensitivity of 95%, specificity of 96.9%, accuracy of 95.9% also compared with that of Lp (a) with a sensitivity of 91%, specificity of 100% and an accuracy of 95.5%. The level of accuracy of Hcy, Cys C and then Lp (a) amongst other indices showed that these diagnostic tools could provide better platform in cardiovascular risk profiling of T2DM patients and should be encouraged.},
 year = {2016}
}

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TY  - JOUR
T1  - Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2
AU  - Brown Holy
AU  - Joshua Marcella Tari
Y1  - 2016/05/03
PY  - 2016
N1  - https://doi.org/10.11648/j.ejpm.20160403.15
DO  - 10.11648/j.ejpm.20160403.15
T2  - European Journal of Preventive Medicine
JF  - European Journal of Preventive Medicine
JO  - European Journal of Preventive Medicine
SP  - 79
EP  - 84
PB  - Science Publishing Group
SN  - 2330-8230
UR  - https://doi.org/10.11648/j.ejpm.20160403.15
AB  - Diabetes mellitus (DM) is characterized by hyperglycaemia and glycosuria due to defects in insulin secretion from the Islets of Langerhans and associated with cardiovascular disease (CVD). The imperativeness to assess effectiveness of various cardiovascular risk tools is critical with increasing rate of people with diabetes type 2. Study was aimed at the assessment and evaluation of the diagnostic relevance of homocysteine, Cystatin C, cardiovascular risk indices in the risk profile of cardiovascular diseases in Type 2 diabetes mellitus patients. A total of 165 patients were involved in the study, of which 100 were diabetic (test) and 65 non-diabetics (control). The diabetic subjects were those whose glycated haemoglobin (HbA1C) levels were ≥ 6.5%. HbA1C was estimated quantitatively by immunochemical method, Homocysteine (Hcy), Cystatin C, Lipoprotein (a) (Lp (a) were measured by Enzyme Linked Immunosorbent assay (ELISA) method; Glucose oxidase method was used for the determination of fasting plasma glucose (FBS). The results showed elevated serum homocysteine (Hcy), Lp (a) among the diabetics as compared to the non-diabetic subjects (p<0.05). The diabetic subjects also depicted higher Cystatin C (Cys C) levels, in the diabetic type 2 patients compared to the non-diabetic patients. The lipid profile levels in the diabetic subjects showed higher mean values of total cholesterol and triglycerides, (p < 0.05) as compared with the non-diabetic. The percentage risk predictive values of cardiovascular disease in the diabetic sub-population with these risk indices showed Hcy with a sensitivity of 96%, specificity of 96.9% and an accuracy of 96.5% as compared to Cys C with a sensitivity of 95%, specificity of 96.9%, accuracy of 95.9% also compared with that of Lp (a) with a sensitivity of 91%, specificity of 100% and an accuracy of 95.5%. The level of accuracy of Hcy, Cys C and then Lp (a) amongst other indices showed that these diagnostic tools could provide better platform in cardiovascular risk profiling of T2DM patients and should be encouraged.
VL  - 4
IS  - 3
ER  -

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Author Information

Brown Holy

Dept. of Medical Laboratory Science, Rivers State University of Science and Technology, Npkolu, Port Harcourt, Nigeria
Joshua Marcella Tari

Dept. of Medical Laboratory Science, Rivers State University of Science and Technology, Npkolu, Port Harcourt, Nigeria

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APA Style

Brown Holy, Joshua Marcella Tari. (2016). Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2. European Journal of Preventive Medicine, 4(3), 79-84. https://doi.org/10.11648/j.ejpm.20160403.15

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ACS Style

Brown Holy; Joshua Marcella Tari. Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2. Eur. J. Prev. Med. 2016, 4(3), 79-84. doi: 10.11648/j.ejpm.20160403.15

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AMA Style

Brown Holy, Joshua Marcella Tari. Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2. Eur J Prev Med. 2016;4(3):79-84. doi: 10.11648/j.ejpm.20160403.15

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@article{10.11648/j.ejpm.20160403.15,
  author = {Brown Holy and Joshua Marcella Tari},
  title = {Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2},
  journal = {European Journal of Preventive Medicine},
  volume = {4},
  number = {3},
  pages = {79-84},
  doi = {10.11648/j.ejpm.20160403.15},
  url = {https://doi.org/10.11648/j.ejpm.20160403.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejpm.20160403.15},
  abstract = {Diabetes mellitus (DM) is characterized by hyperglycaemia and glycosuria due to defects in insulin secretion from the Islets of Langerhans and associated with cardiovascular disease (CVD). The imperativeness to assess effectiveness of various cardiovascular risk tools is critical with increasing rate of people with diabetes type 2. Study was aimed at the assessment and evaluation of the diagnostic relevance of homocysteine, Cystatin C, cardiovascular risk indices in the risk profile of cardiovascular diseases in Type 2 diabetes mellitus patients. A total of 165 patients were involved in the study, of which 100 were diabetic (test) and 65 non-diabetics (control). The diabetic subjects were those whose glycated haemoglobin (HbA1C) levels were ≥ 6.5%. HbA1C was estimated quantitatively by immunochemical method, Homocysteine (Hcy), Cystatin C, Lipoprotein (a) (Lp (a) were measured by Enzyme Linked Immunosorbent assay (ELISA) method; Glucose oxidase method was used for the determination of fasting plasma glucose (FBS). The results showed elevated serum homocysteine (Hcy), Lp (a) among the diabetics as compared to the non-diabetic subjects (p<0.05). The diabetic subjects also depicted higher Cystatin C (Cys C) levels, in the diabetic type 2 patients compared to the non-diabetic patients. The lipid profile levels in the diabetic subjects showed higher mean values of total cholesterol and triglycerides, (p < 0.05) as compared with the non-diabetic. The percentage risk predictive values of cardiovascular disease in the diabetic sub-population with these risk indices showed Hcy with a sensitivity of 96%, specificity of 96.9% and an accuracy of 96.5% as compared to Cys C with a sensitivity of 95%, specificity of 96.9%, accuracy of 95.9% also compared with that of Lp (a) with a sensitivity of 91%, specificity of 100% and an accuracy of 95.5%. The level of accuracy of Hcy, Cys C and then Lp (a) amongst other indices showed that these diagnostic tools could provide better platform in cardiovascular risk profiling of T2DM patients and should be encouraged.},
 year = {2016}
}

Copy | Download

TY  - JOUR
T1  - Diagnostic Value of Homocysteine, Cystatin C and Lipid Indices in Assessment of Cardiovascular Risk Status of Patients with Diabetes Type 2
AU  - Brown Holy
AU  - Joshua Marcella Tari
Y1  - 2016/05/03
PY  - 2016
N1  - https://doi.org/10.11648/j.ejpm.20160403.15
DO  - 10.11648/j.ejpm.20160403.15
T2  - European Journal of Preventive Medicine
JF  - European Journal of Preventive Medicine
JO  - European Journal of Preventive Medicine
SP  - 79
EP  - 84
PB  - Science Publishing Group
SN  - 2330-8230
UR  - https://doi.org/10.11648/j.ejpm.20160403.15
AB  - Diabetes mellitus (DM) is characterized by hyperglycaemia and glycosuria due to defects in insulin secretion from the Islets of Langerhans and associated with cardiovascular disease (CVD). The imperativeness to assess effectiveness of various cardiovascular risk tools is critical with increasing rate of people with diabetes type 2. Study was aimed at the assessment and evaluation of the diagnostic relevance of homocysteine, Cystatin C, cardiovascular risk indices in the risk profile of cardiovascular diseases in Type 2 diabetes mellitus patients. A total of 165 patients were involved in the study, of which 100 were diabetic (test) and 65 non-diabetics (control). The diabetic subjects were those whose glycated haemoglobin (HbA1C) levels were ≥ 6.5%. HbA1C was estimated quantitatively by immunochemical method, Homocysteine (Hcy), Cystatin C, Lipoprotein (a) (Lp (a) were measured by Enzyme Linked Immunosorbent assay (ELISA) method; Glucose oxidase method was used for the determination of fasting plasma glucose (FBS). The results showed elevated serum homocysteine (Hcy), Lp (a) among the diabetics as compared to the non-diabetic subjects (p<0.05). The diabetic subjects also depicted higher Cystatin C (Cys C) levels, in the diabetic type 2 patients compared to the non-diabetic patients. The lipid profile levels in the diabetic subjects showed higher mean values of total cholesterol and triglycerides, (p < 0.05) as compared with the non-diabetic. The percentage risk predictive values of cardiovascular disease in the diabetic sub-population with these risk indices showed Hcy with a sensitivity of 96%, specificity of 96.9% and an accuracy of 96.5% as compared to Cys C with a sensitivity of 95%, specificity of 96.9%, accuracy of 95.9% also compared with that of Lp (a) with a sensitivity of 91%, specificity of 100% and an accuracy of 95.5%. The level of accuracy of Hcy, Cys C and then Lp (a) amongst other indices showed that these diagnostic tools could provide better platform in cardiovascular risk profiling of T2DM patients and should be encouraged.
VL  - 4
IS  - 3
ER  -

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