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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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ROC curve analyses for predictive values of serum cystatin C levels in detecting asymptomatic CAD;ROC, receiver operating characteristic; CAD, coronary artery disease.
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Figure 2: ROC curve analyses for predictive values of serum cystatin C levels in detecting asymptomatic CAD;ROC, receiver operating characteristic; CAD, coronary artery disease.

Mentions: The ability of serum cystatin C levels to distinguish MetS patients with asymptomatic CAD from those without CAD was assessed using ROC curve analysis. The ROC curves for asymptomatic CAD diagnosis had an area under the curve (AUC) of 0.622 (95% CI: 0543–0.701, P = 0.003). A serum cystatin C level of ≥0.825 mg/L predicted the presence of CAD with a sensitivity of 71.3% and specificity of 54.7% (Figure 2).


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)

ROC curve analyses for predictive values of serum cystatin C levels in detecting asymptomatic CAD;ROC, receiver operating characteristic; CAD, coronary artery disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: ROC curve analyses for predictive values of serum cystatin C levels in detecting asymptomatic CAD;ROC, receiver operating characteristic; CAD, coronary artery disease.
Mentions: The ability of serum cystatin C levels to distinguish MetS patients with asymptomatic CAD from those without CAD was assessed using ROC curve analysis. The ROC curves for asymptomatic CAD diagnosis had an area under the curve (AUC) of 0.622 (95% CI: 0543–0.701, P = 0.003). A serum cystatin C level of ≥0.825 mg/L predicted the presence of CAD with a sensitivity of 71.3% and specificity of 54.7% (Figure 2).

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