Department of Central Laboratory, Provincial Hospital affiliated to Shandong University, Jinan, People's Republic of China.
Cardiovasc Diabetol. 2012 Sep 14;11:108. doi: 10.1186/1475-2840-11-108.
All 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.
A 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.
Serum 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.
Serum 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.
代谢综合征（MetS）的所有成分都被认为是冠心病（CAD）的危险因素。在无症状的 MetS 患者中早期发现 CAD 仍然是一个挑战。胱抑素 C 作为肾功能障碍的一种新标志物，与 CAD 患者的死亡率相关。本研究旨在评估胱抑素 C 是否是肾功能正常的无症状 MetS 患者 CAD 的潜在标志物。
本横断面研究共纳入 211 例无症状的 MetS 患者，这些患者均无 CAD 病史。根据冠状动脉造影结果，患者被分为 MetS 伴无症状 CAD（n=136）和 MetS 无 CAD（n=75）两组。使用颗粒增强免疫比浊法测定血清胱抑素 C 水平。首先评估胱抑素 C 是否与无症状 CAD 的存在和严重程度存在独立关联。然后，我们研究了胱抑素 C 与动脉粥样硬化其他生化危险因素之间的关系。
无症状 CAD 患者的血清胱抑素 C 水平明显高于无 CAD 患者（P=0.004）。多因素逻辑回归分析表明，胱抑素 C 与无症状 CAD 的存在独立相关（OR=1.326，95%CI：1.086-1.619）。在受试者工作特征（ROC）分析中，曲线下面积（AUC）为 0.622（95%CI：0.543-0.701，P=0.003），胱抑素 C 具有中等的预测价值。此外，胱抑素 C 与 Gensini 评分独立相关（标准化β=0.183，P=0.007），且血清胱抑素 C 水平随病变血管数量的增加而升高（P=0.005）。多元逐步回归分析显示，尿酸（UA）（P<0.001）、体重指数（BMI）（P=0.002）、甘油三酯（TG）（P=0.03）、估算肾小球滤过率（eGFR）（P<0.001）和纤维蛋白原（P=0.001）与胱抑素 C 独立相关。
在肾功能正常的 MetS 患者中，血清胱抑素 C 与无症状 CAD 的存在和严重程度显著相关，提示胱抑素 C 可能不仅仅是肾小球滤过率的标志物。
Zotero 插件
