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Cystatin C and asymptomatic coronary artery disease in patients with metabolic syndrome and normal glomerular filtration rate.

Qing X, Furong W, Yunxia L, Jian Z, Xuping W, Ling G - Cardiovasc Diabetol (2012)

Bottom Line: Serum cystatin C levels in patients with asymptomatic CAD were significantly higher than those without CAD (P=0.004).In a multiple stepwise regression analysis, uric acid (UA)(P<0.001), body mass index (BMI)(P=0.002), triglyceride(TG)(P=0.03), estimated glomerular filtration rate (eGFR)(P<0.001), and fibrinogen(P=0.001) were independently associated with cystatin C.Serum cystatin C in our study was significantly associated with the presence and severity of asymptomatic CAD in MetS patients with normal kidney function, suggesting that cystatin C is probably more than a marker of glomerular filtration rate.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Central Laboratory, Provincial Hospital affiliated to Shandong University, Jinan, People's Republic of China.

ABSTRACT

Background: All of the components of metabolic syndrome (MetS) have been regarded as risk factors for coronary artery disease (CAD). Early detection of CAD in asymptomatic patients with MetS remains a challenge. Cystatin C,which has been proposed as a novel marker of renal dysfunction,is correlated with mortality in CAD, The purpose of the study was to evaluate whether cystatin C is a potential marker of asymptomatic CAD in MetS patients with normal kidney function.

Methods: A total of 211asymptomatic MetS patients without prior history of CAD patients were included in a cross-sectional study. Patients were divided into MetS with asymptomatic CAD (n=136) and MetS without CAD (n=75) groups according to coronary angiograph results. Serum cystatin C levels were measured using particle enhanced immunonephelometric assays. We first assessed whether there is an independent association of cystatin C with the presence and severity of asymptomatic CAD. Then, we investigated the association between cystatin C and other biochemical risk factors for atherosclerosis.

Results: Serum cystatin C levels in patients with asymptomatic CAD were significantly higher than those without CAD (P=0.004). A multiple logistic regression analysis demonstrated cystatin C was independently associated with the presence of asymptomatic CAD (OR=1.326, 95%CI: 1.086-1.619). On receiver operating characteristics (ROC) analysis, the area under the curve (AUC) was 0.622 (95% CI: 0543-0.701, P=0.003), and cystatin C showed a moderate predictive value. Furthermore, cystatin C was independently correlated with Gensini score (standardized β=0.183, P=0.007), and serum cystatin C levels increased with the increasing of number of disease vessels (P=0.005). In a multiple stepwise regression analysis, uric acid (UA)(P<0.001), body mass index (BMI)(P=0.002), triglyceride(TG)(P=0.03), estimated glomerular filtration rate (eGFR)(P<0.001), and fibrinogen(P=0.001) were independently associated with cystatin C.

Conclusions: Serum cystatin C in our study was significantly associated with the presence and severity of asymptomatic CAD in MetS patients with normal kidney function, suggesting that cystatin C is probably more than a marker of glomerular filtration rate.

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Related in: MedlinePlus

Serum cystatin C levels between MetS patients with asymptomatic CAD (n = 136) and those without CAD (n = 75) (A). CAD, coronary artery disease; MetS, metabolic syndrome. Comparison of serum cystatin C levels according to the number of stenotic coronary arteries (n = 75, 40, 56, 40, respectively, in 0, 1, 2and 3 stenotic vessels group)(B).
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Figure 1: Serum cystatin C levels between MetS patients with asymptomatic CAD (n = 136) and those without CAD (n = 75) (A). CAD, coronary artery disease; MetS, metabolic syndrome. Comparison of serum cystatin C levels according to the number of stenotic coronary arteries (n = 75, 40, 56, 40, respectively, in 0, 1, 2and 3 stenotic vessels group)(B).

Mentions: The characteristics of the study subjects are described in Table 1. The patients with asymptomatic CAD were older than those without CAD(P = 0.011).The rates of hypertension and diabetes mellitus in patients with asymptomatic CAD were higher than in patients without CAD, and asymptomatic CAD patients showed an increase of FPG (P = 0.011). The fibrinogen concentrations were significantly higher in patients with asymptomatic CAD than in those without CAD (P = 0.012). However, there was no difference in sCr, eGFR and lipid profiles between patients with asymptomatic CAD and without CAD. Among the patients with MetS, those with asymptomatic CAD had significantly higher serum cystatin C levels than those without CAD (0.93 ± 0.18 vs 0.86 ± 0.16 mg/L, P = 0.004; Figure 1A).


Cystatin C and asymptomatic coronary artery disease in patients with metabolic syndrome and normal glomerular filtration rate.

Qing X, Furong W, Yunxia L, Jian Z, Xuping W, Ling G - Cardiovasc Diabetol (2012)

Serum cystatin C levels between MetS patients with asymptomatic CAD (n = 136) and those without CAD (n = 75) (A). CAD, coronary artery disease; MetS, metabolic syndrome. Comparison of serum cystatin C levels according to the number of stenotic coronary arteries (n = 75, 40, 56, 40, respectively, in 0, 1, 2and 3 stenotic vessels group)(B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3473246&req=5

Figure 1: Serum cystatin C levels between MetS patients with asymptomatic CAD (n = 136) and those without CAD (n = 75) (A). CAD, coronary artery disease; MetS, metabolic syndrome. Comparison of serum cystatin C levels according to the number of stenotic coronary arteries (n = 75, 40, 56, 40, respectively, in 0, 1, 2and 3 stenotic vessels group)(B).
Mentions: The characteristics of the study subjects are described in Table 1. The patients with asymptomatic CAD were older than those without CAD(P = 0.011).The rates of hypertension and diabetes mellitus in patients with asymptomatic CAD were higher than in patients without CAD, and asymptomatic CAD patients showed an increase of FPG (P = 0.011). The fibrinogen concentrations were significantly higher in patients with asymptomatic CAD than in those without CAD (P = 0.012). However, there was no difference in sCr, eGFR and lipid profiles between patients with asymptomatic CAD and without CAD. Among the patients with MetS, those with asymptomatic CAD had significantly higher serum cystatin C levels than those without CAD (0.93 ± 0.18 vs 0.86 ± 0.16 mg/L, P = 0.004; Figure 1A).

Bottom Line: Serum cystatin C levels in patients with asymptomatic CAD were significantly higher than those without CAD (P=0.004).In a multiple stepwise regression analysis, uric acid (UA)(P<0.001), body mass index (BMI)(P=0.002), triglyceride(TG)(P=0.03), estimated glomerular filtration rate (eGFR)(P<0.001), and fibrinogen(P=0.001) were independently associated with cystatin C.Serum cystatin C in our study was significantly associated with the presence and severity of asymptomatic CAD in MetS patients with normal kidney function, suggesting that cystatin C is probably more than a marker of glomerular filtration rate.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Central Laboratory, Provincial Hospital affiliated to Shandong University, Jinan, People's Republic of China.

ABSTRACT

Background: All of the components of metabolic syndrome (MetS) have been regarded as risk factors for coronary artery disease (CAD). Early detection of CAD in asymptomatic patients with MetS remains a challenge. Cystatin C,which has been proposed as a novel marker of renal dysfunction,is correlated with mortality in CAD, The purpose of the study was to evaluate whether cystatin C is a potential marker of asymptomatic CAD in MetS patients with normal kidney function.

Methods: A total of 211asymptomatic MetS patients without prior history of CAD patients were included in a cross-sectional study. Patients were divided into MetS with asymptomatic CAD (n=136) and MetS without CAD (n=75) groups according to coronary angiograph results. Serum cystatin C levels were measured using particle enhanced immunonephelometric assays. We first assessed whether there is an independent association of cystatin C with the presence and severity of asymptomatic CAD. Then, we investigated the association between cystatin C and other biochemical risk factors for atherosclerosis.

Results: Serum cystatin C levels in patients with asymptomatic CAD were significantly higher than those without CAD (P=0.004). A multiple logistic regression analysis demonstrated cystatin C was independently associated with the presence of asymptomatic CAD (OR=1.326, 95%CI: 1.086-1.619). On receiver operating characteristics (ROC) analysis, the area under the curve (AUC) was 0.622 (95% CI: 0543-0.701, P=0.003), and cystatin C showed a moderate predictive value. Furthermore, cystatin C was independently correlated with Gensini score (standardized β=0.183, P=0.007), and serum cystatin C levels increased with the increasing of number of disease vessels (P=0.005). In a multiple stepwise regression analysis, uric acid (UA)(P<0.001), body mass index (BMI)(P=0.002), triglyceride(TG)(P=0.03), estimated glomerular filtration rate (eGFR)(P<0.001), and fibrinogen(P=0.001) were independently associated with cystatin C.

Conclusions: Serum cystatin C in our study was significantly associated with the presence and severity of asymptomatic CAD in MetS patients with normal kidney function, suggesting that cystatin C is probably more than a marker of glomerular filtration rate.

Show MeSH
Related in: MedlinePlus