Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China.
Health Management Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Clin Rheumatol. 2022 Jul;41(7):2143-2151. doi: 10.1007/s10067-022-06139-6. Epub 2022 Mar 31.
INTRODUCTION/OBJECTIVES: Circulating cystatin C has reportedly been related to cardiovascular disease, diabetes, and metabolic syndrome, apart from its traditional role in estimating the glomerular filtration rate. However, whether circulating cystatin C is related to hyperuricemia remains unclear.
We included 2406 men and 1273 women who attended their annual health checkups in this study. Anthropometric and biochemical parameters were measured. Hyperuricemia was diagnosed as fasting serum uric acid > 420 µmol/L in men and women.
A total of 695 (18.9%) participants were diagnosed with hyperuricemia. Hyperuricemic patients had significantly higher serum cystatin C levels than healthy controls (0.91 (0.83-1.02) versus 0.82 (0.72-0.92) mg/L, P < 0.001). Serum cystatin C levels were positively related to the prevalence of hyperuricemia, which was 5.18%, 14.76%, 22.66%, and 31.24% in participants with serum cystatin C levels in the first, second, third, and fourth quartiles, respectively (P < 0.001 for trend). In stepwise multivariate logistic regression analysis, participants with serum cystatin C in the fourth quartile had a more than twofold increased risk of hyperuricemia (OR 2.262, 95% CI 1.495-3.422; P < 0.001) compared with those with serum cystatin C in the first quartile. In subgroup analyses, the fourth quartile of cystatin C was related to increased risks of hyperuricemia in both non-obese and obese participants (OR 4.405, 95% CI 1.472-13.184, P = 0.008; OR 1.891, 95% CI 1.228-2.911, P = 0.004, respectively), in non-metabolic syndrome participants (OR 3.043, 95% CI 1.692-5.473; P < 0.001) but not in metabolic syndrome participants (OR 1.689, 95% CI 0.937-3.045; P = 0.081), and in non-non-alcoholic fatty liver disease (non-NAFLD) (OR 2.128, 95% CI 1.424-3.180; P < 0.001, respectively) and young and middle-aged participants (OR 2.235, 95% CI 1.492-3.348, P < 0.001) but not in NAFLD and elderly participants.
This study revealed a positive association of circulating cystatin C with hyperuricemia. Key Points • Serum cystatin C is associated with an increased risk of hyperuricemia. • Serum cystatin C is a useful biomarker in distinguishing patients at high risk of having hyperuricemia.
简介/目的：循环胱抑素 C 除了在估计肾小球滤过率方面的传统作用外，据报道还与心血管疾病、糖尿病和代谢综合征有关。然而，循环胱抑素 C 是否与高尿酸血症有关仍不清楚。
我们纳入了在年度健康检查中参加的 2406 名男性和 1273 名女性。测量了人体测量学和生化参数。空腹血清尿酸 > 420 μmol/L 被诊断为高尿酸血症。
共有 695 名（18.9%）参与者被诊断为高尿酸血症。高尿酸血症患者的血清胱抑素 C 水平明显高于健康对照组（0.91（0.83-1.02）与 0.82（0.72-0.92）mg/L，P<0.001）。血清胱抑素 C 水平与高尿酸血症的患病率呈正相关，血清胱抑素 C 水平处于第一、二、三、四分位数的参与者中高尿酸血症的患病率分别为 5.18%、14.76%、22.66%和 31.24%（P<0.001 趋势）。在逐步多元逻辑回归分析中，血清胱抑素 C 处于第四四分位数的参与者发生高尿酸血症的风险增加了两倍以上（OR 2.262，95%CI 1.495-3.422；P<0.001）与血清胱抑素 C 处于第一四分位数的参与者相比。在亚组分析中，胱抑素 C 的第四四分位数与非肥胖和肥胖参与者（OR 4.405，95%CI 1.472-13.184，P=0.008；OR 1.891，95%CI 1.228-2.911，P=0.004）、非代谢综合征参与者（OR 3.043，95%CI 1.692-5.473；P<0.001）中高尿酸血症的风险增加有关，但与代谢综合征参与者（OR 1.689，95%CI 0.937-3.045；P=0.081）、非非酒精性脂肪性肝病（非-NAFLD）（OR 2.128，95%CI 1.424-3.180；P<0.001）和中青年参与者（OR 2.235，95%CI 1.492-3.348，P<0.001）中高尿酸血症的风险增加有关，但与 NAFLD 和老年参与者无关。
本研究揭示了循环胱抑素 C 与高尿酸血症之间存在正相关。
关键点
• 血清胱抑素 C 与高尿酸血症的风险增加有关。
• 血清胱抑素 C 是区分高尿酸血症高危患者的有用生物标志物。
