Abbas et al (2021): Assessment of serum cystatin C level in Type 2 diabetes with early carotid atherosclerosis © Annals of Tropical Medicine & Public Health DOI: http://doi.org/10.36295/ASRO.2021.24526 190 | Page Assessment of serum cystatin C level in type 2 diabetic patients with early carotid atherosclerosis Ahmad Saad Abbas 1* , Abdulkareem H. Issa 1 , Abbas Mahdi Rahmah 2 , Ahmed Al-Sabbagh 2 1. Department of Chemistry and biochemistry, College of Medicine, Mustansiriyah University /Iraq 2. National Diabetes Center, Mustansiriyah University/Iraq Correspondent: Ahmad Saad Abbas asd232020@gmail.com Abstract Background: Coronary heart disease (CHD) is prevalent in type 2 diabetes mellitus (T2DM) where atherosclerotic plaques tend to be more severe and extensive and to affect multiple coronary arteries compared to age-matched non diabetic patients. Cystatin C is an abundant inhibitor of cysteine proteasesand might be involved in development of atherosclerosis. Objectives: To measure serum levels of cystatin C in type 2 diabetic patients with high carotid intima-media thickness (CIMT) and study its association with other atherosclerosis risk factors like hypertension, obesity, and dyslipidemia. Patients &Methods: This cross-sectional study enrolled 88 T2DM patients (males &females) for whom CIMT value were measured by B- mode ultrasonography and a CIMT value of> 0.89 mm was considered as high. Forty four patients were randomly selected with a high CIMT value and 44 patients with a normal CIMT value. For each study patient, clinical characteristics were recorded and serum cystatin C level was measured in addition to basic laboratory tests that included serum glucose, urea, creatinine, and lipids. An estimation of glomerular filtration rate (eGFR) was also done. Results: There was a highly significant increase of serum cystatin C level in high CIMT patients compared to normal CIMT patients (P< 0.001). The high CIMT patients also had a highly significant increase in triglycerides (P< 0.000) and a significant decrease in high-density lipoprotein cholesterol (P < 0.026). Their cystatin C levels showed a significant and a positivecorrelation with CIMT values (r = 0.233, P < 0.029). Comparison of cystatin Cand CIMT values of study patients according to their eGFR revealed significantly higher values in patients with mildly reduced eGFR compared to those with normal eGFR (13.30 ± 2.80 vs. 12.18 ± 2.38 ng/L, P < 0.0357, and 0.8385 ± 0.2178 vs. 0.6723 ± 0.1331 mm, P < 0.017, respectively). Cystatin C levels had no significant correlations with CIMT values in patients with mildly reduced eGFR. Conclusion: Serum cystatin C levels are significantly increased in high CIMT patients compared to normal CIMT patients and the levels had no significant correlations with CIMT values in patients with mildly reduced eGFR referring to a probable role for cystatin C in atherosclerosis independent of renal function. The further finding of significant correlations between CIMT and some risk factors of atherosclerosis like age, body mass index and diastolic blood pressure may indirectly suggest a role for cystatin C in pathogenesis of atherosclerosis. Keywords: Carotid Atherosclerosis, Cystatin C, Type 2 Diabetes Mellitus DOI: http://doi.org/10.36295/ASRO.2021.24526 Page: 190-198 Volume/Issue: Volume: 24 Issue: 05