Liu Pengju, Ma Fang, Lou Huiping, Zhu Yanning
From the Departments of 1Clinical Nutrition, 2Medical Examination Center, and 3Obstetrics and Gynecology, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, China.
Menopause. 2015 Feb;22(2):217-23. doi: 10.1097/GME.0000000000000306.
Although studies have shown that elevated cystatin C (Cys-C) levels are associated with the risk of metabolic syndrome (MetS) in the general population, few studies have examined the relationship between serum Cys-C levels and MetS, stratified by menopause status, among women in China. Therefore, we conducted this study to assess the relationship between Cys-C levels and MetS in Chinese premenopausal and postmenopausal women.
We performed a cross-sectional analysis of the baseline data of 1,428 Chinese community-dwelling women who participated in the annual health checkup. MetS was defined by the updated National Cholesterol Education Program/Adult Treatment Panel III criteria. Binary logistic regression analysis was performed to estimate the association between Cys-C levels and MetS. One-way analysis of variance, followed by posttest for linear trends, was performed to evaluate the relationships between Cys-C levels and the number of MetS components. Ordinal regression analysis was used to determine whether menopause status and MetS components contribute to elevated levels of Cys-C.
The mean level of Cys-C was significantly higher in women with MetS than in those without MetS among both premenopausal and postmenopausal women, showing a progressive increase (P for trend < 0.001) in parallel with the progressive increment in the number of MetS components in all women. Higher Cys-C levels were found to be associated with the presence of MetS after adjusting for age, body mass index, and estimated glomerular filtration rate in all women. The higher odds ratio changed little, even after further adjustment for serum blood nitrogen, total cholesterol, low-density lipoprotein cholesterol, drinking status, and smoking status. Elevated Cys-C level was significantly associated with postmenopause status (P = 0.007), increased waist circumference (P = 0.006), and elevated blood pressure (P = 0.025).
Higher serum Cys-C levels are positively and independently associated with the presence of MetS in Chinese premenopausal and postmenopausal women. Elevated Cys-C levels are significantly associated with postmenopause status.
尽管研究表明,在普通人群中,胱抑素C(Cys-C)水平升高与代谢综合征(MetS)风险相关,但在中国女性中,很少有研究按绝经状态分层研究血清Cys-C水平与MetS之间的关系。因此,我们开展本研究以评估中国绝经前和绝经后女性Cys-C水平与MetS之间的关系。
我们对1428名参加年度健康检查的中国社区女性的基线数据进行了横断面分析。MetS根据更新后的美国国家胆固醇教育计划/成人治疗小组第三次报告标准进行定义。采用二元逻辑回归分析评估Cys-C水平与MetS之间的关联。进行单因素方差分析,随后进行线性趋势的事后检验,以评估Cys-C水平与MetS组分数量之间的关系。采用有序回归分析确定绝经状态和MetS组分是否导致Cys-C水平升高。
在绝经前和绝经后女性中,患有MetS的女性的Cys-C平均水平显著高于未患MetS的女性,且随着所有女性MetS组分数量的逐渐增加呈渐进性升高(趋势P<0.001)。在对所有女性的年龄、体重指数和估计肾小球滤过率进行校正后,发现较高的Cys-C水平与MetS的存在相关。即使在进一步校正血清血氮、总胆固醇、低密度脂蛋白胆固醇、饮酒状况和吸烟状况后,较高的比值比变化也不大。Cys-C水平升高与绝经后状态(P=0.007)、腰围增加(P=0.006)和血压升高(P=0.025)显著相关。
在中国绝经前和绝经后女性中,较高的血清Cys-C水平与MetS的存在呈正相关且独立相关。Cys-C水平升高与绝经后状态显著相关。