Vigil Luis, Lopez Manuel, Condés Emilia, Varela Manuel, Lorence Dulce, Garcia-Carretero Rafael, Ruiz Julian
Hypertension Unit, Department of Internal Medicine.
J Am Soc Hypertens. 2009 May-Jun;3(3):201-9. doi: 10.1016/j.jash.2009.01.002. Epub 2009 Mar 9.
Serum cystatin C has been associated with cardiovascular disease. We investigated whether cystatin C concentration is associated with the metabolic syndrome and with other cardiovascular risk factors in a hypertensive population. In this cross-sectional study, we prospectively included 611 essential hypertensive patients during a 12-month period. Cystatin C concentration was measured by nephelometry. The metabolic syndrome was present in 46% of the patients. Cystatin C was significantly higher in patients with the metabolic syndrome (0.94 +/- 0.27 mg/L) than in those without (0.87 +/- 0.23 mg/L) (P < .0001). Pearson partial correlation analysis showed a significant correlation between cystatin C and body mass index (r = 0.240; P = .001); waist circumference (r = 0.173; P = .012); microalbuminuria (r = 0.273; P < .0001); triglycerides (r = 0.138; P = .047); C-reactive protein (r = 0.190; P = .006); uric acid (r = 0.284; P < .0001); age (r = 0.409; P < .0001); and glomerular filtration rate (GFR) (r = -0.638; P < .0001). Multivariate analysis showed that GFR (B = -0.0061; 95% confidence interval [CI], -0.0073 to -0.0049; P < .0001), age (B = 0.0023; 95% CI, 0.0005-0.0041; P = .009), microalbuminuria (B = 0.0005; 95% CI, 0.0002-0.0007; P < .0001), uric acid (B = 0.0252; 95% CI, 0.0085-0.0418; P = .003), body mass index (B = 0.0051, 95% CI, 0.0012-0.0089; P = .011), and C-reactive protein (B = 0.0048; 95% CI, 0.0015-0.0082; P = .005) were independent determinants of cystatin C concentration. Measuring cystatin C concentration in hypertensive patients may be useful for evaluating their cardiovascular risk profile.
血清胱抑素C与心血管疾病有关。我们调查了在高血压人群中，胱抑素C浓度是否与代谢综合征及其他心血管危险因素相关。在这项横断面研究中，我们前瞻性地纳入了611例原发性高血压患者，研究为期12个月。采用散射比浊法测定胱抑素C浓度。46%的患者存在代谢综合征。有代谢综合征的患者胱抑素C水平（0.94±0.27mg/L）显著高于无代谢综合征的患者（0.87±0.23mg/L）（P<0.0001）。Pearson偏相关分析显示，胱抑素C与体重指数（r=0.240；P=0.001）、腰围（r=0.173；P=0.012）、微量白蛋白尿（r=0.273；P<0.0001）、甘油三酯（r=0.138；P=0.047）、C反应蛋白（r=0.190；P=0.006）、尿酸（r=0.284；P<0.0001）、年龄（r=0.409；P<0.0001）以及肾小球滤过率（GFR）（r=-0.638；P<0.0001）显著相关。多变量分析显示，GFR（B=-0.0061；95%置信区间[CI]，-0.0073至-0.0049；P<0.0001）、年龄（B=0.0023；95%CI，0.0005 - 0.0041；P=0.009）、微量白蛋白尿（B=0.0005；95%CI，0.0002 - 0.0007；P<0.0001）、尿酸（B=0.0252；95%CI，0.0085 - 0.0418；P=0.003）、体重指数（B=0.0051，95%CI，0.0012 - 0.0089；P=0.011）以及C反应蛋白（B=0.0048；95%CI，0.0015 - 0.0082；P=0.005）是胱抑素C浓度的独立决定因素。检测高血压患者的胱抑素C浓度可能有助于评估其心血管风险状况。
