Nedeljkovic Biljana Bozic, Loncar Goran, Vizin Tjasa, Radojicic Zoran, Brkic Vera Popovic, Kos Janko
Faculty of Biology, University of Belgrade, Belgrade Serbia.
Institute for Medical Research, Military Medical Academy, Belgrade, Serbia.
J Med Biochem. 2019 Mar 1;38(1):53-62. doi: 10.2478/jomb-2018-0011. eCollection 2019 Mar.
The aim of the study was to investigate the association of Cystatin C (CysC) to biochemical markers of bone turnover and bone mass, and to evaluate its prognostic significance in elderly males with chronic heart failure (CHF).
A prospective cohort study was executed on sixtyeight males (mean age 68±7 years) with mild to moderate CHF, together with 19 of corresponding age- and body mass index-matched healthy individuals who underwent cardio vascular, bone mineral density (BMD), and body com position assessment. Biochemical assessment of all subjects included NT-pro-BNP, parathyroid hormone (PTH), 25-hydroxy vitamin D (25(OH)D), CysC, and biochemical markers of bone turnover including osteocalcin (OC), alkaline phosphatase (ALP), β-CrossLaps (β-CTx), osteoprotegerin (OPG), and receptor activator of nuclear factor κB ligand (RANKL).
Serum CysC was significantly increased in males with CHF in comparison to healthy control ones. A significant positive association was found between CysC levels and OC in males with CHF, while OC and β-CTx increased in increasing CysC tertiles. In multivariate regression analysis, OC and smoking were a significant determinant of CysC in males with CHF. Level of CysC was found to be positively associated with an increased fatal risk in males with CHF.
Serum osteocalcin is an independent predictor of CysC level in elderly males with CHF. Higher CysC level showed a negative relation to survival and bone loss in males with CHF. Further research is needed to confirm the potential role of CysC in the crosstalk between heart, kidney, bone, and energy metabolism in CHF.
本研究旨在探讨胱抑素C（CysC）与骨转换和骨量生化标志物之间的关联，并评估其在老年慢性心力衰竭（CHF）男性患者中的预后意义。
对68名轻度至中度CHF男性患者（平均年龄68±7岁）以及19名年龄和体重指数匹配的健康个体进行了一项前瞻性队列研究，这些个体均接受了心血管、骨密度（BMD）和身体成分评估。所有受试者的生化评估包括N末端B型利钠肽原（NT-pro-BNP）、甲状旁腺激素（PTH）、25-羟基维生素D（25(OH)D）、CysC，以及骨转换生化标志物，包括骨钙素（OC）、碱性磷酸酶（ALP）、β-交联C端肽（β-CTx）、骨保护素（OPG）和核因子κB受体活化因子配体（RANKL）。
与健康对照组相比，CHF男性患者的血清CysC显著升高。在CHF男性患者中，CysC水平与OC之间存在显著正相关，而OC和β-CTx随着CysC三分位数的增加而升高。在多变量回归分析中，OC和吸烟是CHF男性患者CysC的重要决定因素。发现CysC水平与CHF男性患者的死亡风险增加呈正相关。
血清骨钙素是老年CHF男性患者CysC水平的独立预测因子。较高的CysC水平与CHF男性患者的生存率和骨质流失呈负相关。需要进一步研究以证实CysC在CHF患者心脏、肾脏、骨骼和能量代谢相互作用中的潜在作用。
