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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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Correlation between serum cystatin C and the severity of asymptomatic CAD evaluated by Gensini score. CAD, coronary artery disease.
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Figure 3: Correlation between serum cystatin C and the severity of asymptomatic CAD evaluated by Gensini score. CAD, coronary artery disease.

Mentions: Spearman correlation analysis showed that serum cystatin C (r = 0.188, P = 0.006; Figure 3) was positively correlated with the Gensini score. We further performed a multivariate stepwise regression analysis to evaluate the association between serum cystatin C levels and the Gensini score in a model including age, sex, BMI, smoking, hypertension, and diabetes as well as TC LDL-c, HDL-c, TG SBP, DBP, fibrinogen, FPG, eGFR and cystatin C. The adjustment for the covariates did not change the associations significantly. Serum cystatin C was the independent factor that significantly influenced the Gensini score (standardized β = 0.183, P = 0.007, 95%CI: 0.602-3.844, Table 4).


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)

Correlation between serum cystatin C and the severity of asymptomatic CAD evaluated by Gensini score. CAD, coronary artery disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Correlation between serum cystatin C and the severity of asymptomatic CAD evaluated by Gensini score. CAD, coronary artery disease.
Mentions: Spearman correlation analysis showed that serum cystatin C (r = 0.188, P = 0.006; Figure 3) was positively correlated with the Gensini score. We further performed a multivariate stepwise regression analysis to evaluate the association between serum cystatin C levels and the Gensini score in a model including age, sex, BMI, smoking, hypertension, and diabetes as well as TC LDL-c, HDL-c, TG SBP, DBP, fibrinogen, FPG, eGFR and cystatin C. The adjustment for the covariates did not change the associations significantly. Serum cystatin C was the independent factor that significantly influenced the Gensini score (standardized β = 0.183, P = 0.007, 95%CI: 0.602-3.844, Table 4).

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