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

Cardiovascular Diabetology

Original Investigation

Gao Ling¹  Xie Qing²  Zhang Jian³  Liu Yunxia⁴  Wang Furong⁵  Wang Xuping⁶ 

[1] Department of Central Laboratory, Provincial Hospital affiliated to Shandong University, Jinan, People’s Republic of China;Department of Central Laboratory, Provincial Hospital affiliated to Shandong University, Jinan, People’s Republic of China;Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, People’s Republic of China;Institute of Pharmacology, School of Medicine Shandong University, Jinan, People’s Republic of China;Department of Clinical Laboratory, Qilu Hospital of Shandong University, Jinan, People’s Republic of China;Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, People’s Republic of China;Department of Pharmacology, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China;The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital of Shandong University, Jinan, People’s Republic of China;

关键词: Cystatin C;    Gensini score;    Metabolic syndrome;    Asymptomatic coronary artery disease;   

DOI  :  10.1186/1475-2840-11-108

 received in 2012-06-27, accepted in 2012-08-21,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundAll 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.MethodsA 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.ResultsSerum 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.ConclusionsSerum 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.

【 授权许可】

Unknown   
© Qing et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.