Articles Vol. 67 No. CĐ4-HN Ký sinh trùng-HN Hóa sinh 2026 21/04/2026

CREATININE-TO-CYSTATIN C RATIO AND DISCORDANCE IN RENAL FUNCTION ASSESSMENT AMONG OUTPATIENTS WITH TYPE 2 DIABETES MELLITUS DURING ACUTE HYPERGLYCEMIA

Le Tuyet Minh Chau1,2, Tran Truong Trung Tinh1,2, Nguyen Tan Duc3,4, Le Quoc Tuan1,2
1 University of Medicine and Pharmacy at Ho Chi Minh city
2 Đại học Y Dược thành phố Hồ Chí Minh
3 Department of Biochemistry, Military Hospital 175
4 Khoa Sinh hóa, Bệnh viện Quân y 175
DOI: 10.52163/yhc.v67iCD4.4860
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Keywords
Creatinine-to-cystatin C ratio, acute hyperglycemia, type 2 diabetes mellitus, renal function.
Abstract

Objective: This study compared the creatinine-to-cystatin C ratio and examined its associations with metabolic characteristics and renal function in patients with and without acute hyperglycemia.

Methods: A case-control study was conducted in 76 outpatients with type 2 diabetes mellitus, including 38 patients with acute hyperglycemia (fasting glucose ≥ 180 mg/dL) and 38 patients age- and sex-matched stable controls. Variables included BMI, fasting glucose, HbA1c, serum creatinine, cystatin C, and urinary albumin-to-creatinine ratio. Estimated glomerular filtration rate (GFR) was calculated using the CKD-EPI (2021) creatinine equation and the CKD-EPI (2012) cystatin C equation. Pearson or Spearman correlation analyses were performed.

Results: The hyperglycemia group had higher BMI, HbA1c, creatinine, urinary albumin-to-creatinine ratio, and creatinine-to-cystatin C ratio, but lower cystatin C (p < 0.001). eGFR-Cre decreased, whereas eGFR-Cys increased compared with controls (p < 0.001). The creatinine-to-cystatin C ratio reversed its correlation with BMI between groups and was no longer associated with HbA1c or eGFR-Cre in the hyperglycemia group.

Conclusions: Acute hyperglycemia is associated with discordance between creatinine and cystatin C. The creatinine-to-cystatin C ratio may serve as an adjunctive marker for renal function assessment during acute metabolic stress.

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