Abstract
BackgroundRenal function is a key factor of cardiovascular disease. Carotid intima-media thickness (IMT) has been widely used as a marker of early subclinical atherosclerosis. The determinants of cystatin C, a novel marker of renal function, have not been extensively studied in the Asian population. This study aimed to assess the determinants of cystatin C and explore whether carotid thickening was associated with urinary albumin-creatinine ratio and cystatin C in community-living Taiwanese adults.MethodsA cross-sectional study was conducted on participants from Taichung City, Taiwan. All the participants underwent carotid ultrasonography. Carotid IMT-mean and IMT-maximum were derived. Kidney biomarkers were measured on the basis of urinary albumin-to-creatinine ratio (ACR) and cystatin C. Multiple linear regression analysis was used.ResultsA total of 1032 individuals were recruited, and 469 (45.44%) of them were men. An increased cystatin C level was significantly associated with older age, male gender, lack of physical activity, low HDL cholesterol, abdominal obesity, high hs-CRP, and high ACR. The multivariate-adjusted mean carotid IMT-mean and IMT-maximum values significantly increased by 80.49 and 195.23 μm for every one unit of increase in cystatin C level and by 0.07 and 0.14 μm for every one unit of increase in ACR, respectively (all p < 0.001 except ACR on IMT-maximum with p < 0.01). Lack of physical activity, low HDL, abdominal obesity, high hs-CRP, and high ACR were the determinants of cystatin C.ConclusionCystatin C and ACR were strongly and linearly associated with carotid thickening, a marker of subclinical atherosclerosis.
Highlights
Renal function is a key factor of cardiovascular disease
The highest tertile of cystain C was associated with the high proportions of men, smoking, lack of physical activity, hyperglycemia, hypertriglyceridemia, hypertension, low High density lipoprotein (HDL) cholesterol, and high mean values of age, fasting insulin, High sensitivity C-reactive protein (hs-CRP), carotid intima-media thickness (IMT)-mean, and IMT-maximum
Our findings showed that the metabolic components of abdominal obesity and low HDL cholesterol were determinants of cystatin C, and they were consistent with those of prior studies showing that cystatin C is associated with metabolic syndrome [28, 29], obesity determined by Body mass index (BMI) [30,31,32], and HDL [33]
Summary
Renal function is a key factor of cardiovascular disease. Carotid intima-media thickness (IMT) has been widely used as a marker of early subclinical atherosclerosis. Cystatin C is considered as an ideal marker of renal function [3] and more precise than serum creatinine levels in detecting early kidney dysfunction [4, 5]. Plasma cystatin C measurement is superior to creatinine-based methods for estimating the glomerular filtration rate [3, 6] in terms of its greater sensitivity than creatinine as a predictor of cardiovascular risk and for the early diagnosis of early chronic renal disease. In addition to cystatin C, albuminuria is a renal marker associated with an increased risk of CVD. Albuminuria is a marker of generalized endothelial dysfunction in which accelerated atherosclerosis [9] has been known as a sensitive prognostic marker to evaluate the increased risk of CVD [10, 11]. Urinary albumincreatinine ratio (ACR) is a preferred approach for albuminuria detection
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
