Serum cystatin C and the incidence of hypertension in type 1 diabetes mellitus

Background Serum cystatin has been shown to be associated with hypertension in the general population. Little is known on the relationship of serum cystatin C with the long-term hypertension incidence in persons with diabetes. We examined the association of serum cystatin C with the incidence of hypertension over a 15-year period in people with type 1 diabetes mellitus. Methods The 15-year cumulative incidence of hypertension was measured in Wisconsin Epidemiologic Study of Diabetic Retinopathy participants. Hypertension was defined as a systolic blood pressure (BP) of ≥140mmHg and/or a diastolic BP of ≥90mmHg and/or history of use of antihypertensive treatment. The relation of cystatin C and other risk factors to hypertension incidence was determined with generalized linear modeling with the complementary log-log link function. Results After controlling for age, gender, diabetes duration, body mass index (BMI), glycosylated hemoglobin, and baseline systolic and diastolic BP, the baseline serum cystatin C was associated with the 15-year cumulative incidence of hypertension (hazard ratio (HR) per mg/l of cystatin C: 3.43, and 95% confidence interval: 1.36, 8.63). Conclusions These findings show a relationship of serum cystatin C with the incidence of hypertension in type 1 diabetes mellitus. The underlying biological processes remain to be determined.