Wen Yufeng, Xia Dan, Wang Yanchun, Zhang Huiping, Li Haibo, Ali Gholam, Gao Yongqing, Li Jian, Sun Wenjie, Li Linlin
School of Public Health, Wannan Medical College, Wuhu, Anhui, China.
Kidney Blood Press Res. 2016;41(2):197-207. doi: 10.1159/000443422. Epub 2016 Mar 25.
BACKGROUND/AIMS: The relationship between carotid artery plaque burden, phenotype and serum cystatin C at normal and impaired renal function is still unclear.
Demographic characteristics, carotid ultrasonography and other relevant information of 1,477 patients were collected. The association of carotid artery plaque burden, plaque phenotype with serum cystatin C was evaluated by strategy analysis based on renal function.
Serum cystatin C (OR=2.05, 95% CI: 1.83-2.29, P<.01) was a risk factor of stable plaque among patients with normal glomerular filtration rate. However, in the patients with mild impaired renal function, serum cystatin C was not only a risk factor for stable plaque (OR=1.60, 95% CI: 1.43-1.78, P<.001) but also was a risk factor for unstable plaque (OR=1.21, 95% CI: 1.10-1.32, P<.001). The smoothing function curve and a three-piecewise linear regression revealed that a nonlinear relationship was observed between serum cystatin C and plaque burden. When serum cystatin C was in the range of 0.75-1.30 (mg/L), the plaque burden tended to increase.
In normal renal function, serum cystatin C may confer stability of plaques. In mildly impaired renal function, serum cystatin C is a risk predictor of plaques. In normal renal function circumstances, serum cystatin C may benefit to the stability of plaques. In mild impaired renal function circumstances, serum cystatin C are a risk predictors of plaques.
背景/目的:在肾功能正常和受损的情况下,颈动脉斑块负荷、表型与血清胱抑素C之间的关系仍不清楚。
收集1477例患者的人口统计学特征、颈动脉超声检查及其他相关信息。基于肾功能,通过策略分析评估颈动脉斑块负荷、斑块表型与血清胱抑素C的相关性。
在肾小球滤过率正常的患者中,血清胱抑素C(OR=2.05,95%CI:1.83-2.29,P<0.01)是稳定斑块的危险因素。然而,在轻度肾功能受损的患者中,血清胱抑素C不仅是稳定斑块的危险因素(OR=1.60,95%CI:1.43-1.78,P<0.001),也是不稳定斑块的危险因素(OR=1.21,95%CI:1.10-1.32,P<0.001)。平滑函数曲线和三段式线性回归显示,血清胱抑素C与斑块负荷之间存在非线性关系。当血清胱抑素C在0.75-1.30(mg/L)范围内时,斑块负荷趋于增加。
在肾功能正常时,血清胱抑素C可能赋予斑块稳定性。在轻度肾功能受损时,血清胱抑素C是斑块的风险预测因子。在肾功能正常的情况下,血清胱抑素C可能有利于斑块的稳定性。在轻度肾功能受损的情况下,血清胱抑素C是斑块的风险预测因子。