Association between Cystatin C and Arteriosclerosis in the Absence of Chronic Kidney Disease

Abstract

Aim: Chronic kidney disease (CKD) is a known risk factor for cardiovascular disease (CVD). Cystatin C was recently reported to be an endogenous surrogate of kidney function, and a high level of cystatin C is reported to be a strong predictor of CVD; however, the association between cystatin C and arteriosclerosis in a non-CKD population is unclear. This study aimed to clarify the association between cystatin C and arteriosclerosis in a non-CKD population. Methods: Of the 637 Japanese adults (264 men, 373 women) enrolled, we analyzed 446 participants with an estimated glomerular filtration rate (eGFR) ＞60 mL/min and no proteinuria (177 men, 269 women) without a history of CVD. Kidney function was evaluated according to serum cystatin C levels and eGFR. Arteriosclerosis was evaluated on the basis of the cardio-ankle vascular index (CAVI) and carotid intima-media thickness (CIMT). Results: The mean age of our subjects was 67.0±10.0 years. No variables showed any significant differences according to gender. The results of multiple linear regression analysis showed a significant correlation between serum cystatin C and CAVI only in women, but not CIMT. Conclusion:We observed a significant correlation between cystatin C and CAVI, which is a marker of early-stage arteriosclerosis, in women in a non-CKD population with no proteinuria and eGFR ＞60 mL/min. J Atheroscler Thromb, 2013; 20:548-556.

Comparison of cystatin C- and creatinine-based estimated glomerular filtration rate to predict coronary heart disease risk in Japanese patients with obesity and diabetes

“…Previous studies reported the correlation between cystatin C and CAVI in patients with cardiovascular risk factors [14], or in women in a non-CKD population (eGFR > 60 mL/ min/1.73 m 2 ) [15]. These findings are compatible with that of our present study in Japanese patients with obesity and diabetes, who have mild renal dysfunction and have no history of CVD.…”

Assessment of Serum Cystatin C as an Early Biomarker of Carotid Atherosclerosis

“…The lifestyle habits of the two subgroups did not differ significantly. Serum Cys C levels were reported to correlate significantly with eGFR and proved more sensitive in detecting early impairment of renal function than serum creatinine [26][27][28]. Our results support this hypotensis, as serum Cys C values were significantly correlated with eGFR.…”

“…The prognostic value of serum Cys C cut-off level = 0.73 mg/dL identified in our study was different possibly because of using age and gender adjustments in the multivariate analysis. In a recent Japanese study, Yamashita et al [28] attempted to clarify the association between Cys C and arteriosclerosis in the absence of chronic kidney disease in 637 patients, observing a strong correlation between Cys C and the cardio-ankle vascular index, which is an early marker for the detection of atherosclerosis in women [43]. Our results were differently due to the fact that our study group included more men and the parameters used to define atherosclerosis were differently.…”

Serum Osteoprotegerin is Associated with Arterial Stiffness Assessed According to the Cardio-ankle Vascular Index in Hypertensive Patients

“…The CAVI correlates independently with the estimated GFR in the general Japanese population 24) , whereas, in renal insufficiency patients, the CAVI values are closely associated with the cystatin C levels 25) . Another report noted a significant correlation between the serum cystatin C level and the CAVI only in women in a non-chronic kidney disease population 26) . A decreased GFR is a key determinant of arterial stiffness in hypertensive patients with a normal renal function 27) .…”