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Nagy EE, Puskás A, Kelemen P, Makó K, Brassai Z, Hársfalvi J, Frigy A. Elevated Serum Cystatin C and Decreased Cathepsin S/Cystatin C Ratio Are Associated with Severe Peripheral Arterial Disease and Polyvascular Involvement. Diagnostics (Basel) 2022; 12:diagnostics12040833. [PMID: 35453881 PMCID: PMC9029365 DOI: 10.3390/diagnostics12040833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/21/2022] [Accepted: 03/26/2022] [Indexed: 11/16/2022] Open
Abstract
Peripheral arterial disease (PAD) is frequently associated with atherosclerotic manifestations of the carotids and coronaries. Polyvascular involvement and low ankle−brachial index predict major cardiovascular events and high mortality. Cathepsin S (Cat S) promotes the inflammatory pathways of the arterial wall, while Cystatin C (Cys C) functions as its inhibitor; therefore, Cys C was proposed to be a biomarker of progression in PAD. In a single-center observational study, we investigated the correlations of serum Cys C and Cat S/Cys C ratio in a group of 90 PAD patients, predominantly with polyvascular involvement. Cys C and Cat S/Cys C were associated with ankle−brachial index (ABI) scores <0.4 in univariate and multiple regression models. Furthermore, both markers correlated positively with the plasma Von Willebrand Factor Antigen (VWF: Ag) and Von Willebrand Factor collagen-binding activity (VWF: CB). In addition, Cat S/Cys C was significantly decreased, whereas Cys C increased in subjects with three-bed atherosclerotic involvement. According to our results, high serum Cys C and low Cat S/Cys C ratios may indicate severe peripheral arterial disease and polyvascular atherosclerotic involvement.
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Affiliation(s)
- Előd Ernő Nagy
- Department of Biochemistry and Environmental Chemistry, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
- Laboratory of Medical Analysis, Clinical County Hospital Mures, 540394 Targu Mures, Romania
- Correspondence: ; Tel.: +40-733-956-395
| | - Attila Puskás
- Angio-Center Vascular Medicine, 540074 Targu Mures, Romania;
- Department of Internal Medicine II, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (P.K.); (K.M.); (Z.B.)
- II Clinic of Internal Medicine, Emergency Clinical County Hospital Targu Mures, 540142 Targu Mures, Romania
| | - Piroska Kelemen
- Department of Internal Medicine II, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (P.K.); (K.M.); (Z.B.)
- II Clinic of Internal Medicine, Emergency Clinical County Hospital Targu Mures, 540142 Targu Mures, Romania
| | - Katalin Makó
- Department of Internal Medicine II, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (P.K.); (K.M.); (Z.B.)
- II Clinic of Internal Medicine, Emergency Clinical County Hospital Targu Mures, 540142 Targu Mures, Romania
- Hestia General Practioner Ltd., H-1188 Budapest, Hungary
| | - Zoltán Brassai
- Department of Internal Medicine II, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (P.K.); (K.M.); (Z.B.)
- II Clinic of Internal Medicine, Emergency Clinical County Hospital Targu Mures, 540142 Targu Mures, Romania
| | - Jolán Hársfalvi
- Department of Biophysics and Radiation Biology, Faculty of Medicine, Semmelweis University, H-1444 Budapest, Hungary;
| | - Attila Frigy
- Department of Internal Medicine IV, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
- Department of Cardiology, Clinical County Hospital Mures, 540072 Targu Mures, Romania
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Jing Y, Shi J, Lu B, Zhang W, Yang Y, Wen J, Hu R, Yang Z, Wang X. Association of Circulating Cathepsin S and Cardiovascular Disease Among Patients With Type 2 Diabetes: A Cross-Sectional Community-Based Study. Front Endocrinol (Lausanne) 2021; 12:615913. [PMID: 33746900 PMCID: PMC7973458 DOI: 10.3389/fendo.2021.615913] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/01/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cathepsin S, as an adipokine, was reported to play a critical role in various disease, including atherosclerosis and diabetes. The present study aims to elucidate the relationship between circulating cathepsin S and cardiovascular disease (CVD) in patients with type 2 diabetes. METHODS A total of 339 type 2 diabetes individuals were enrolled in this cross-sectional community-based study. Basic information, medical and laboratory data were collected. Serum cathepsin S levels were assessed by ELISA. RESULTS Compared to the CVD (-) group, levels of serum cathepsin S were significantly higher in the CVD (+) group, with the median 23.68 ng/ml (18.54-28.02) and 26.81 ng/ml (21.19-37.69) respectively (P < 0.001). Moreover, patients with acute coronary syndrome (ACS) had substantially higher levels of serum cathepsin S than those with stable angina pectoris (SAP), with the median 34.65 ng/ml (24.33-42.83) and 25.52 ng/ml (20.53-31.47) respectively (P < 0.01). The spearman correlation analysis showed that circulating cathepsin S was correlated with several cardiovascular risk factors. The univariate and multivariate logistic regression analysis revealed that circulating cathepsin S was an independent risk factor for CVD (all P < 0.001) after adjustment for potential confounders. Restricted cubic spline analysis showed circulating cathepsin S had a linearity association with CVD. In addition, receiver operating characteristic (ROC) curve analysis demonstrated that the area under curve (AUC) values of cathepsin S was 0.80 (95% CI: 0.75-0.84, P < 0.001), with the optimal cutoff value of cathepsin 26.28 ng/ml. CONCLUSION Circulating cathepsin S was significantly higher in the CVD (+) group than that in the CVD (-) one among type 2 diabetes. The increased serum cathepsin S levels were associated with increased risks of CVD, even after adjusting for potential confounders. Thus, cathepsin S might be a potential diagnostic biomarker for CVD.
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Affiliation(s)
- Yu Jing
- Department of Endocrinology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jie Shi
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bin Lu
- Department of Endocrinology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weiwei Zhang
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yehong Yang
- Department of Endocrinology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jie Wen
- Department of Endocrinology, Huashan Hospital, Fudan University, Shanghai, China
| | - Renming Hu
- Department of Endocrinology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhen Yang
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Zhen Yang, ; Xuanchun Wang,
| | - Xuanchun Wang
- Department of Endocrinology, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Zhen Yang, ; Xuanchun Wang,
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