Abstract
Purpose Osteoporosis is a common age-related disorder leading to increased bone fragility and risk of fracture. Early diagnosis of osteoporosis is a vital step in providing early therapeutic intervention. Serum cystatin C is a marker of early renal dysfunction, a predictor of cardiovascular and inflammatory diseases, and an inhibitor of the differentiation of osteoclast precursor cells. The purpose of this study was to evaluate the relationship between serum cystatin C and osteoporosis. Methods We enrolled 46 subjects who attended a health checkup and underwent measurement of bone status by quantitative ultrasound and determination of the level of serum cystatin C. A comparative study was conducted between those with and without osteoporosis for all subjects collectively and in two subgroups aged <65 and ≥65 years. Results Serum cystatin C levels were strongly correlated with age, creatinine, and bone status data, with significant negative correlations with stiffness, T-score, and percentage of young adult mean. Among patients with osteoporosis, serum cystatin C was significantly higher even after adjustment for age and sex, whereas no significant difference was noted in creatinine. For patients aged ≥ 65 years, serum cystatin C was significantly higher in subjects with osteoporosis, although there was no significant difference in age between normal subjects and those with osteoporosis. Conclusions To the best of our knowledge, this is the first study to demonstrate an association between serum cystatin C and osteoporosis. Serum cystatin C is significantly higher in osteoporosis and in particular may be a useful marker for osteoporosis among middle and elderly people aged ≥ 65 years. Measurement of serum cystatin C can be carried out easily and may contribute to early diagnosis and treatment of osteoporosis.
Highlights
The World Health Organization (WHO) defines osteoporosis as a disease characterized by low bone mass and the microarchitectural deterioration of bone tissue, leading to increased bone fragility and risk of fracture [1, 2]
Serum cystatin C (p = 0.042) showed significant differences between normal and osteoporosis subjects (Table 3), there was no significant difference in terms of age (p = 0.070), sex (p = 0.062), creatinine (p = 0.42), and C-reactive protein (CRP) (p = 0.69)
Serum cystatin C level correlates with glomerular filtration rate [23], which is an important marker of kidney health and determinant of the progression of both diabetes and chronic kidney disease [25, 26]
Summary
The World Health Organization (WHO) defines osteoporosis as a disease characterized by low bone mass and the microarchitectural deterioration of bone tissue, leading to increased bone fragility and risk of fracture [1, 2]. The incidence of osteoporosis has steadily increased in recent decades as a consequence of societal ageing, with approximately 200 million osteoporotic patients worldwide and approximately 8.9 million osteoporotic fractures [3]. These types of fractures, along with spinal kyphosis, are the most important factors underlying the reduced quality of life and survival of elderly patients [4, 5]. Serum cystatin C is a sensitive indicator of early renal dysfunction and a strong independent predictor of CVD, diabetes-related mortality, and all-cause mortality [7, 8]. Recent evidence from the Japanese Orthopedic Association suggested that serum cystatin C can be an early predictor of locomotive
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