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Hong X, Rosenberg AZ, Heymann J, Yoshida T, Waikar SS, Ilori TO, Wang G, Rebuck H, Pearson C, Wang M, Winkler CA, Kopp JB, Wang X. Joint Associations of Pregnancy Complications and Postpartum Maternal Renal Biomarkers With Severe Cardiovascular Morbidities: A US Racially and Ethnically Diverse Prospective Birth Cohort Study. J Am Heart Assoc 2023; 12:e029311. [PMID: 37947096 PMCID: PMC10727285 DOI: 10.1161/jaha.122.029311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 07/25/2023] [Indexed: 11/12/2023]
Abstract
Background Pregnancy complications are risk factors for cardiovascular disease (CVD). Little is known about the role of renal biomarkers measured shortly after delivery, individually or in combination with pregnancy complications, in predicting subsequent severe maternal CVD. Methods and Results This study included 566 mothers of diverse races and ethnicities from the Boston Birth cohort, enrolled at delivery and followed prospectively. Plasma creatinine and CysC (cystatin C) were measured 1 to 3 days after delivery. CVD during follow-up was defined by physician diagnoses in electronic medical records. Associations of renal biomarkers and pregnancy complications with time-to-CVD events were assessed using Cox proportional hazards models. During an average of 10.3±3.2 years of follow-up, 30 mothers developed 1 or more CVDs. Only a modest association was observed between creatinine and risk of CVD. In comparison, we found that per 0.1 mg/L increase of CysC was associated with a hazard ratio (HR) of 1.2 (95% CI, 1.1-1.4) for CVD after adjusting for covariates. Compared with those without preeclampsia and with normal CysC level (≤75th percentile), mothers with preeclampsia and elevated CysC (>75th percentile) had the highest risk of CVD (HR, 4.6 [95% CI, 1.7-17.7]), whereas mothers with preeclampsia only or with elevated CysC only did not have significantly increased CVD risk. Similar synergistic effects for CVD were observed between CysC and preterm delivery. Conclusions In this sample of US, traditionally underrepresented multiracial and multiethnic high-risk mothers, elevated maternal plasma CysC, independently and jointly with pregnancy complications, increased risk of CVD later in life. These findings warrant further investigation. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03228875.
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Affiliation(s)
- Xiumei Hong
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of DiseaseJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
| | | | - Jurgen Heymann
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of HealthMDBethesdaUSA
| | - Teruhiko Yoshida
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of HealthMDBethesdaUSA
| | - Sushrut S. Waikar
- Section of Nephrology, Department of MedicineBoston University Chobanian & Avedisian School of Medicine and Boston Medical CenterBostonMAUSA
| | - Titilayo O. Ilori
- Section of Nephrology, Department of MedicineBoston University Chobanian & Avedisian School of Medicine and Boston Medical CenterBostonMAUSA
| | - Guoying Wang
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of DiseaseJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
| | - Heather Rebuck
- Clinical Chemistry Research LabUniversity of Maryland School of MedicineBaltimoreMDUSA
| | - Colleen Pearson
- Department of PediatricsBoston University Chobanian & Avedisian School of Medicine and Boston Medical CenterBostonMAUSA
| | - Mei‐Cheng Wang
- Department of BiostatisticsJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
| | - Cheryl A. Winkler
- Cancer Innovation Laboratory, Center for Cancer ResearchNational Cancer Institute and Basic Research Program, Frederick National LaboratoryFrederickMDUSA
| | - Jeffrey B. Kopp
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of HealthMDBethesdaUSA
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of DiseaseJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
- Division of General Pediatrics & Adolescent Medicine, Department of PediatricsJohns Hopkins University School of MedicineBaltimoreMDUSA
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Xu X, Zhang G, Li Z, Li D, Chen R, Huang C, Li Y, Li B, Yu H, Chu XM. MINOCA biomarkers: Non-atherosclerotic aspects. Clin Chim Acta 2023; 551:117613. [PMID: 37871762 DOI: 10.1016/j.cca.2023.117613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 10/25/2023]
Abstract
Myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) is an important subtype of myocardial infarction. Although comprising less than 50% stenosis in the main epicardial coronary arteries, it constitutes a severe health risk. A variety of approaches have been recommended, but definitive diagnosis remains elusive. In addition, the lack of a comprehensive understanding of underlying pathophysiology makes clinical management difficult and unpredictable. This review highlights ongoing efforts to identify relevant biomarkers in MINOCA to improve diagnosis, individualize treatment and better predict outcomes.
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Affiliation(s)
- Xiaojian Xu
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
| | - Guoliang Zhang
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
| | - Zhaoqing Li
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
| | - Daisong Li
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
| | - Ruolan Chen
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
| | - Chao Huang
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
| | - Yonghong Li
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
| | - Bing Li
- Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, Qingdao 266000, China; Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Haichu Yu
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
| | - Xian-Ming Chu
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China; The Affiliated Cardiovascular Hospital of Qingdao University, Qingdao 266071, China.
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Hong X, Rosenberg AZ, Heymann J, Yoshida T, Waikar SS, Ilori TO, Wang G, Rebuck H, Pearson C, Wang MC, Winkler CA, Kopp JB, Wang X. Joint associations of pregnancy complications and postpartum maternal renal biomarkers with severe cardiovascular morbidities: A US racially diverse prospective birth cohort study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.14.23287276. [PMID: 36993418 PMCID: PMC10055449 DOI: 10.1101/2023.03.14.23287276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Rationale & Objective Pregnancy complications are risk factors for cardiovascular diseases (CVD). Little is known about the role of renal biomarkers measured shortly after delivery, individually or in combination with pregnancy complications, in predicting subsequent severe maternal CVD. Methods This study included 576 mothers of diverse ethnicities from the Boston Birth cohort, enrolled at delivery and followed prospectively. Plasma creatinine and cystatin C were measured 1-3 days after delivery. CVD during follow-up was defined by physician diagnoses in electronic medical records. Associations of renal biomarkers and pregnancy complications with time-to-CVD events were assessed using Cox proportional hazards models. Results During an average of 10.3±3.2 years of follow-up, 34 mothers developed one or more CVD events. Although no significant associations were found between creatinine and risk of CVD, per unit increase of cystatin C (CysC) was associated with a hazard ratio (HR) of 5.21 (95%CI = 1.49-18.2) for CVD. A borderline significant interactive effect was observed between elevated CysC (≥75th percentile) and preeclampsia. Compared to those without preeclampsia and with normal CysC level (<75 th percentile), mothers with preeclampsia and elevated CysC had the highest risk of CVD (HR=3.8, 95%CI = 1.4-10.2), while mothers with preeclampsia only or with elevated CysC only did not have significantly increased CVD risk. Similar synergistic effects for CVD were observed between CysC and preterm delivery. Conclusions In this sample of US, traditionally under-represented multi-ethnic high-risk mothers, elevated maternal plasma cystatin C and pregnancy complications synergistically increased risk of CVD later in life. These findings warrant further investigation. Clinical Perspectives What is new?Maternal postpartum elevated levels of cystatin C are independently associated with higher risk of cardiovascular diseases (CVD) later in life.Maternal pregnancy complications coupled with postpartum elevated levels of cystatin C synergistically increased future risk of CVD.What are the clinical implications?These findings, if further confirmed, suggest that women with pregnancy complications and elevated postpartum cystatin C may be at particular high risk for CVD later in life compared to women without these risk factors.
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Effects of Serum LDL-C, CysC, and D-D in Patients with Coronary Atherosclerotic Heart Disease. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:5771960. [PMID: 35800677 PMCID: PMC9256368 DOI: 10.1155/2022/5771960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/31/2022] [Indexed: 01/09/2023]
Abstract
Objective To investigate the effects of low-density lipoprotein cholesterol (LDL-C) and serum cystatin C (CysC) combined with D-dimer (D-D) on patients with coronary atherosclerotic heart disease (CHD). Methods 90 patients with CHD who were admitted to our hospital and diagnosed by coronary angiography (CAG) from February 2020 to June 2021 were selected as the study subjects. 90 patients were grouped according to different types and branches of coronary lesions, and 30 patients with outpatient health check-ups at the same period were selected as the control group, and the differences in serum LDL-C, CysC, and D-D levels between the groups were compared. The logistic regression model was built to explore risk factors affecting the occurrence of CHD. Also, receiver operating characteristic (ROC) curves were drawn to analyze the diagnostic value of LDL-C, CysC, and D-D in CHD. Results In the comparison of LDL-C, CysC, and D-D levels, CHD group > control group (P < 0.05); stable angina (SAP) group > unstable angina (UAP) group > acute myocardial infarction (AMI) group (P < 0.05); three-branch group > two-branch group > single-branch group (P < 0.05). The logistic regression model showed that high expression levels of LDL-C, CysC, and D-D, male gender, and combined hypertension were risk factors for CHD. The area under the curve (AUC) of the combination of LDL-C, CysC, and D-D was 0.868, and the sensitivity and specificity were 88.89% and 73.33%, respectively, which are higher than those in single diagnosis (P < 0.05). Conclusions LDL-C, CysC, and D-D are highly expressed in CHD samples, and the combination of the three is beneficial to enhance the diagnostic accuracy of clinical CHD.
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West M, Kirby A, Stewart RA, Blankenberg S, Sullivan D, White HD, Hunt D, Marschner I, Janus E, Kritharides L, Watts GF, Simes J, Tonkin AM. Circulating Cystatin C Is an Independent Risk Marker for Cardiovascular Outcomes, Development of Renal Impairment, and Long-Term Mortality in Patients With Stable Coronary Heart Disease: The LIPID Study. J Am Heart Assoc 2022; 11:e020745. [PMID: 35179040 PMCID: PMC9075058 DOI: 10.1161/jaha.121.020745] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background Elevated plasma cystatin C levels reflect reduced renal function and increased cardiovascular risk. Less is known about whether the increased risk persists long‐term or is independent of renal function and other important biomarkers. Methods and Results Cystatin C and other biomarkers were measured at baseline (in 7863 patients) and 1 year later (in 6106 patients) in participants in the LIPID (Long‐Term Intervention with Pravastatin in Ischemic Disease) study, who had a previous acute coronary syndrome. Outcomes were ascertained during the study (median follow‐up, 6 years) and long‐term (median follow‐up, 16 years). Glomerular filtration rate (GFR) was estimated using Chronic Kidney Disease Epidemiology Collaboration equations (first GFR‐creatinine, then GFR‐creatinine‐cystatin C). Over 6 years, in fully adjusted multivariable time‐to‐event models, with respect to the primary end point of coronary heart disease mortality or nonfatal myocardial infarction, for comparison of Quartile 4 versus 1 of baseline cystatin C, the hazard ratio was 1.37 (95% CI, 1.07–1.74; P=0.01), and for major cardiovascular events was 1.47 (95% CI, 1.19–1.82; P<0.001). Over 16 years, the association of baseline cystatin C with coronary heart disease, cardiovascular, and all‐cause mortality persisted (each P<0.001) and remained significant after adjustment for estimated GFR‐creatinine‐cystatin C. Cystatin C also predicted the development of chronic kidney disease for 6 years (odds ratio, 6.61; 95% CI, 4.28–10.20) independently of estimated GFR‐creatinine and other risk factors. However, this association was no longer significant after adjustment for estimated GFR‐creatinine‐cystatin C. Conclusions Cystatin C independently predicted major cardiovascular events, development of chronic kidney disease, and cardiovascular and all‐cause mortality. Prediction of long‐term mortality was independent of improved estimation of GFR. Registration URL: https://anzctr.org.au; Unique identifier: ACTRN12616000535471.
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Affiliation(s)
- Malcolm West
- Department of MedicineUniversity of QueenslandBrisbaneAustralia
| | - Adrienne Kirby
- National Health and Medical Research Council Clinical Trials CentreUniversity of SydneySydneyAustralia
| | - Ralph A. Stewart
- Green Lane Cardiovascular ServiceAuckland City HospitalUniversity of AucklandAucklandNew Zealand
| | | | - David Sullivan
- Department of Chemical PathologyRoyal Prince Alfred HospitalSydneyAustralia
| | - Harvey D. White
- Green Lane Cardiovascular ServiceAuckland City HospitalUniversity of AucklandAucklandNew Zealand
| | - David Hunt
- Cardiology DepartmentRoyal Melbourne HospitalMelbourneAustralia
| | - Ian Marschner
- National Health and Medical Research Council Clinical Trials CentreUniversity of SydneySydneyAustralia
| | - Edward Janus
- Department of MedicineWestern Health Chronic Disease AllianceWestern HealthMelbourne Medical SchoolUniversity of MelbourneMelbourneAustralia
| | - Leonard Kritharides
- Department of CardiologyConcord Repatriation General HospitalSydney Local Health DistrictSydneyAustralia
- ANZAC Medical Research InstituteFaculty of MedicineUniversity of SydneySydneyAustralia
| | - Gerald F. Watts
- School of MedicineFaculty of Health and Medical SciencesUniversity of Western AustraliaPerthAustralia
| | - John Simes
- National Health and Medical Research Council Clinical Trials CentreUniversity of SydneySydneyAustralia
| | - Andrew M. Tonkin
- School of Public Health and Preventive MedicineMonash UniversityPerthAustralia
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CHANGES OF APELIN-13 AND CYSTATIN C LEVELS AND METABOLIC PROFILE IN PATIENTS WITH HYPERTENSION AND FREQUENT VENTRICULAR EXTRASYSTOLE. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-1-79-85-90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Association between serum cystatin C level and hemodynamically significant aortic stenosis: a prospective cohort study. J Geriatr Cardiol 2021; 18:986-995. [PMID: 35136394 PMCID: PMC8782761 DOI: 10.11909/j.issn.1671-5411.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Cystatin C (CysC) is a cysteine protease inhibitor involved in proteins catabolism and plays an essential role in human vascular pathophysiology. CysC may also increase the risk of aortic stenosis (AS), but limited studies have reported on this association. This study aimed to investigate if elevated serum CysC levels are associated with hemodynamically significant AS. METHODS Serum CysC levels were estimated in 4,791 participants, samples were collected in 1990-1992. The study population was divided into quintile groups. Follow-up continued in 2011-2013 when participants returned for echocardiography examination. Incidence of aortic valve disease (AVD) was ascertained by Doppler echocardiography through the end of 2013. AVD defined in hemodynamic progression was assessed and classified as aortic sclerosis, mild stenosis, and moderate-to-severe stenosis. RESULTS Overall, a total of 4,791 participants (mean age: 54.8 ± 5.0 years, females: 57.6%, blacks: 8.2%) were included in this study. During a follow-up of 21 years, we identified 736 cases (15.4%) of aortic sclerosis, 194 cases (4.0%) of mild stenosis, and 42 cases (0.7%) of moderate-to-severe stenosis. Compared with serum CysC levels within individual quintile groups, the odds ratio (OR) was per standard deviation associated with an increased incidence of AVD (OR = 1.15, 95% CI: 1.05-1.26,P = 0.002). CONCLUSIONS In this large population-based study, an increased serum CysC levels is independently associated with the incidence of hemodynamically significant AS. However, this association appears not to extend to patients with extremely high serum CysC levels and necessitate further investigation.
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Chen Z, Zhang J, Feng J, Zhou G, Jin X, Pan J. Higher serum level of Cystatin C: An additional risk factor of CAD. Medicine (Baltimore) 2021; 100:e24269. [PMID: 33466214 PMCID: PMC7808466 DOI: 10.1097/md.0000000000024269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/11/2020] [Indexed: 01/05/2023] Open
Abstract
Cystatin C has been proposed as a useful biomarker of early impaired kidney function and a predictor of mortality risk. The present study is to investigate the association between serum Cystatin C and the severity of coronary artery lesions, Gensini score (GS), and the risk of coronary artery disease (CAD).A total of 682 CAD patients (230 females, 452 males; mean age 62.6 ± 10.7 years, range from 31 to 86 years) and 135 controls (41 females, 94 males; mean age 58.0 ± 10.3 years, range from 38 to 84 years) were recruited in the present study. Enzyme-linked immunosorbent assay was applied to measure serum cystatin C levels and other serum indexes. The estimated glomerular filtration rate and GS were calculated.Serum low-density lipoprotein cholesterol (LDL-C), uric acid, Cystatin C, and homocysteine (HCY) were significantly elevated in CAD patients compared to controls. There were significant differences regarding total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, cystatin C, eGFR and GS among stable angina pectoris (SAP), unstable angina group (UAP), and acute myocardial infarction (AMI) patients. AMI group had an elevated serum Cystatin C, LDL-C, HCY, and GS than SAP and UAP patients. When stratified patient groups by the quartiles of Cystatin C, we found age, the proportion of male and patients with diabetes, HCY, and GS were increased in Q4 than in other quartile groups. Spearman correlation test revealed a positive relationship between Cystatin C, HCY, and GS. Multivariate logistic regression analysis revealed that serum Cystatin C level, presence of hypertension and diabetes, HCY, age, and male were the risk factors for coronary artery lesions.In summary, our results suggested that cystatin C is a promising clinical biomarker that provides complementary information to the established risk determinants. The serum Cystatin C level is strongly associated with GS and could be used to evaluate the severity of coronary artery lesions.
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Affiliation(s)
- Zhenfei Chen
- Department of Cardiology, The Second Hospital of Hefei City, Hefei, Anhui, China
| | - Jing Zhang
- Department of Cardiology, The Second Hospital of Hefei City, Hefei, Anhui, China
| | - Jun Feng
- Department of Cardiology, The Second Hospital of Hefei City, Hefei, Anhui, China
| | - Gaoliang Zhou
- Department of Cardiology, The Second Hospital of Hefei City, Hefei, Anhui, China
| | - Xiaoqin Jin
- Department of Cardiology, The Second Hospital of Hefei City, Hefei, Anhui, China
| | - Jianyuan Pan
- Department of Cardiology, The Second Hospital of Hefei City, Hefei, Anhui, China
- DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg University, Germany
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Jin S, Xu J, Shen G, Gu P. Predictive value of circulating cystatin C level in patients with acute coronary syndrome: a meta-analysis. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 81:1-7. [PMID: 33207943 DOI: 10.1080/00365513.2020.1846212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Circulating cystatin C level has been identified as a predictor of adverse outcomes in patients with coronary artery disease (CAD). This meta-analysis aimed to investigate the value of circulating cystatin C level for predicting adverse outcomes in patients with acute coronary syndrome (ACS). We comprehensively searched articles indexed in Pubmed and Embase databases from their inceptions to 30 November 2019. All available observational studies that investigated the association between circulating cystatin C level and major adverse cardiovascular events [MACE] (including death, heart failure, re-infarction, target vascular revascularization, angina and stroke) or all-cause mortality in patients with ACS were included. The prognostic value was expressed by pooling the multivariable-adjusted hazard risk (HR) with 95% confidence interval (CI) for the highest versus the lowest category of cystatin C level. Eleven eligible studies (12 articles) with 4600 ACS patients were identified. Meta-analysis indicated that the highest versus lowest category of cystatin C level was associated with higher risk of MACE (HR 2.28; 95% CI 1.92-2.71) and all-cause mortality (HR 2.89; 95% CI 1.43-5.83) after adjustment for estimated glomerular filtration rate (eGFR) or creatinine. Subgroup analysis by subtypes of patients, study design, follow-up duration and cutoff level of cystatin C further confirmed the value of cystatin C level for predicting MACE. Elevated circulating cystatin C level at baseline is strongly and independently associated with an increased risk of MACE and all-cause mortality in patients with ACS. Determination of circulating cystatin C level has potential to improve risk stratification of ACS patients.
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Affiliation(s)
- Song Jin
- Department of Geriatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, PR China
| | - Jian Xu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, PR China
| | - Gan Shen
- Department of Geriatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, PR China
| | - Pengying Gu
- Department of Geriatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, PR China
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Ma L, Dai W, Lin Y, Zhang Z, Pan Y, Han H, Jia H, Peng J, Zhao J, Xu L. Leukocyte Rho kinase activity and serum cystatin C affect cardiovascular events in acute coronary syndrome. Medicine (Baltimore) 2020; 99:e20060. [PMID: 32664054 PMCID: PMC7360209 DOI: 10.1097/md.0000000000020060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This study was designed to investigate the effects of leukocyte Rho kinase activity and serum Cystatin C (Cys C) on cardiovascular events in patients with acute coronary syndrome (ACS). METHODS A total of 48 patients with ST-segment elevation myocardial infarction (STEMI), 23 patients with non-ST-segment elevation myocardial infarction (NSTEMI), 25 patients with unstable angina (UA) and 20 patients with no-acute coronary syndrome as control from January 2017 to June 2018 in Tianyou Hospital affiliated to Wuhan University of Science and Technology were selected in this study. Western blot was used to detect the leukocyte Rho kinase activity and Elisa kit was used to measure serum Cys C. Univariate and multivariate analysis were used to analyze the influencing factors of cardiovascular events in ACS patients. RESULTS The activity of leukocyte Rho kinase and serum Cys C were gradually reduced in the STEMI, NSTEMI and UA patients, but all significantly higher than that in No-ASC patients, and there was a positive correlation between leukocyte Rho kinase activity and serum Cys C in ACS patients (r = 0.516, P < .001). The activity of leukocyte Rho kinase was positively correlated with the levels of serum TNF-α (r = 0.634, P < .001), IL-6 (r = 0.578, P < .001), IL-8 (r = 0.582, P < .001) in ACS patients, and the level of Cys C was positively correlated with the levels of serum TNF-α (r = 0.634, P < .001), IL-6 (r = 0.578, P < .001), IL-8 (r = 0.582, P < .001) in ACS patients. Univariate and multivariate analysis showed that the leukocyte Rho kinase activity (HR = 2.994, 95%CI = 1.328-6.054, P < .0001) and the levels of serum Cys C (HR = 1.692, 95%CI = 1.028-2.124, P < .0001) were independent influencing factors of cardiovascular events in ACS patients. CONCLUSION The leukocyte Rho kinase activity and serum Cystatin C are high in acute coronary syndrome patients, and are the independent influencing factors of cardiovascular events in ACS patients.
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Affiliation(s)
- Li Ma
- Department of Cardiology, Tianyou Hospital Affiliated to Wuhan University of Science and Technology
| | - Wenqin Dai
- Department of Cardiology, Tianyou Hospital Affiliated to Wuhan University of Science and Technology
- Department of Cardiology, Wuchang Hospital of Wuhan
| | - Yongbo Lin
- Department of Cardiology, People's Hospital of Dongxihu
| | - Zhongyuan Zhang
- Department of Pharmacy, Tianyou Hospital Affiliated to Wuhan University of Science and Technology
| | - Yunhong Pan
- Department of Cardiology, Tianyou Hospital Affiliated to Wuhan University of Science and Technology
| | - Hongyan Han
- Department of Cardiology, Tianyou Hospital Affiliated to Wuhan University of Science and Technology
| | - Haizhen Jia
- Department of Cardiology, Tianyou Hospital Affiliated to Wuhan University of Science and Technology
| | - Jun Peng
- Department of Cardiology, Tianyou Hospital Affiliated to Wuhan University of Science and Technology
| | - Jinhe Zhao
- Department of Cardiology, Tianyou Hospital Affiliated to Wuhan University of Science and Technology
| | - Liang Xu
- Department of Intensive Care Unit, WuHan, China
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Hao Q, Gottesman RF, Qiao Y, Liu L, Sharma R, Selvin E, Matsushita K, Coresh J, Wasserman BA. Association between kidney disease measures and intracranial atherosclerosis: The ARIC study. Neurology 2020; 94:e2361-e2372. [PMID: 32303651 PMCID: PMC7357292 DOI: 10.1212/wnl.0000000000009311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/29/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To test the association between reduced kidney function (assessed by estimated glomerular filtration rate [eGFR] and cystatin C [CysC]) and kidney damage (assessed by urinary albumin-to-creatinine ratio [ACR]) and intracranial atherosclerotic disease (ICAD) by high-resolution vessel wall MRI (VWMRI) in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS). METHODS We conducted a cross-sectional analysis of ARIC participants with data on kidney measures and VWMRI in 2011 to 2013. The main outcomes were presence of intracranial plaques and luminal stenosis. Multivariable models were adjusted for demographics, cardiovascular risk factors, and use of antithrombotic medications. RESULTS A total of 1,762 participants (mean ± SD age, 76.3 ± 5.3) were included. eGFR based on CysC (eGFRcysc) <60 mL/min/1.73 m2 (vs ≥60 mL/min/1.73 m2) was associated with plaque presence (adjusted odds ratio [OR] 1.29, 95% confidence interval [CI] 1.04-1.60), any detectable stenosis (adjusted OR 1.31, 95% CI 1.04-1.63), and >70% stenosis or occlusion (adjusted OR 2.15, 95% CI 1.32-3.50). Neither ACR nor CysC showed statistically significant associations with ICAD features in adjusted models. In adjusted multinomial models, participants with eGFRcysc <60 mL/min/1.73 m2 (vs ≥60 mL/min/1.73 m2) had an increased OR of 1.41 (95% CI 1.06-1.87) for having 1 plaque (vs none) but no significant increase for multiple plaques; ACR ≥30 was associated with moderate (50%-70%) stenosis (OR 2.01, 95% CI 1.14-3.55) vs absent or less than 50% stenosis. CONCLUSION In community-dwelling older adults, reduced kidney function or elevated kidney damage was associated with ICAD measured by VWMRI. This finding may help to better identify a population at high risk for ICAD.
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Affiliation(s)
- Qing Hao
- From the Department of Neurology (Q.H.), Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Neurology (R.F.G.) and Radiology (Y.Q., L.L., B.A.W.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.S.), Yale School of Medicine, New Haven, CT; Department of Epidemiology (E.S., K.M.), Johns Hopkins Bloomberg School of Public Health; and Departments of Epidemiology (J.C.), Biostatistics(J.C.), and Medicine (J.C.), Johns Hopkins Medical Institutions, Baltimore, MD
| | - Rebecca F Gottesman
- From the Department of Neurology (Q.H.), Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Neurology (R.F.G.) and Radiology (Y.Q., L.L., B.A.W.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.S.), Yale School of Medicine, New Haven, CT; Department of Epidemiology (E.S., K.M.), Johns Hopkins Bloomberg School of Public Health; and Departments of Epidemiology (J.C.), Biostatistics(J.C.), and Medicine (J.C.), Johns Hopkins Medical Institutions, Baltimore, MD
| | - Ye Qiao
- From the Department of Neurology (Q.H.), Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Neurology (R.F.G.) and Radiology (Y.Q., L.L., B.A.W.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.S.), Yale School of Medicine, New Haven, CT; Department of Epidemiology (E.S., K.M.), Johns Hopkins Bloomberg School of Public Health; and Departments of Epidemiology (J.C.), Biostatistics(J.C.), and Medicine (J.C.), Johns Hopkins Medical Institutions, Baltimore, MD
| | - Li Liu
- From the Department of Neurology (Q.H.), Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Neurology (R.F.G.) and Radiology (Y.Q., L.L., B.A.W.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.S.), Yale School of Medicine, New Haven, CT; Department of Epidemiology (E.S., K.M.), Johns Hopkins Bloomberg School of Public Health; and Departments of Epidemiology (J.C.), Biostatistics(J.C.), and Medicine (J.C.), Johns Hopkins Medical Institutions, Baltimore, MD
| | - Richa Sharma
- From the Department of Neurology (Q.H.), Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Neurology (R.F.G.) and Radiology (Y.Q., L.L., B.A.W.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.S.), Yale School of Medicine, New Haven, CT; Department of Epidemiology (E.S., K.M.), Johns Hopkins Bloomberg School of Public Health; and Departments of Epidemiology (J.C.), Biostatistics(J.C.), and Medicine (J.C.), Johns Hopkins Medical Institutions, Baltimore, MD
| | - Elizabeth Selvin
- From the Department of Neurology (Q.H.), Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Neurology (R.F.G.) and Radiology (Y.Q., L.L., B.A.W.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.S.), Yale School of Medicine, New Haven, CT; Department of Epidemiology (E.S., K.M.), Johns Hopkins Bloomberg School of Public Health; and Departments of Epidemiology (J.C.), Biostatistics(J.C.), and Medicine (J.C.), Johns Hopkins Medical Institutions, Baltimore, MD
| | - Kunihiro Matsushita
- From the Department of Neurology (Q.H.), Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Neurology (R.F.G.) and Radiology (Y.Q., L.L., B.A.W.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.S.), Yale School of Medicine, New Haven, CT; Department of Epidemiology (E.S., K.M.), Johns Hopkins Bloomberg School of Public Health; and Departments of Epidemiology (J.C.), Biostatistics(J.C.), and Medicine (J.C.), Johns Hopkins Medical Institutions, Baltimore, MD
| | - Josef Coresh
- From the Department of Neurology (Q.H.), Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Neurology (R.F.G.) and Radiology (Y.Q., L.L., B.A.W.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.S.), Yale School of Medicine, New Haven, CT; Department of Epidemiology (E.S., K.M.), Johns Hopkins Bloomberg School of Public Health; and Departments of Epidemiology (J.C.), Biostatistics(J.C.), and Medicine (J.C.), Johns Hopkins Medical Institutions, Baltimore, MD
| | - Bruce A Wasserman
- From the Department of Neurology (Q.H.), Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Neurology (R.F.G.) and Radiology (Y.Q., L.L., B.A.W.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.S.), Yale School of Medicine, New Haven, CT; Department of Epidemiology (E.S., K.M.), Johns Hopkins Bloomberg School of Public Health; and Departments of Epidemiology (J.C.), Biostatistics(J.C.), and Medicine (J.C.), Johns Hopkins Medical Institutions, Baltimore, MD.
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12
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Cheng Y, Xu C, Wang S, Hou L, Guan Q, Zhou X. Serum cystatin C levels are decreased in type 1 diabetes mellitus patients with diabetic ketoacidosis. MINERVA ENDOCRINOL 2020; 45:106-116. [PMID: 32340426 DOI: 10.23736/s0391-1977.20.03147-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cystatin C is a marker of renal function and risk factor for cardiovascular disease. Patients with acute myocardial infarction showed a significant decrease in cystatin C levels. It is unknown whether reduced serum cystatin C levels are connected to acute events or represent a negative acute phase response. The current study aimed to assess the association between cystatin C and the existence of diabetic ketoacidosis (DKA), an acute event in individuals with type 1 diabetes mellitus (T1DM). METHODS Cystatin C was measured in the control group (N.=322) and in T1DM patients with (N.=161) and without DKA (N.=146). Data were compared according to diabetes and ketoacidosis status. Correlation analysis was used to identify factors associated with cystatin C levels. A multiple stepwise regression analysis was used to determine which of the parameters that were significantly correlated with cystatin C in univariate analysis were independently related to cystatin C. Then, we assessed the independent association between cystatin C and the occurrence of DKA in T1DM patients. RESULTS Serum cystatin C levels were lower in patients with DKA than in patients without DKA. After adjustment for age, sex, fasting plasma glucose and creatinine, cystatin C was positively correlated with the duration of diabetes, systolic blood pressure (SBP), total cholesterol, triglycerides, uric acid and low-density lipoprotein cholesterol (P=0.004, P=0.022, P=0.013, P=0.035, P=0.006, P=0.012, respectively) and negatively correlated with hemoglobin (P<0.001). The duration of diabetes (P<0.001), total cholesterol (P=0.002), hemoglobin (P<0.001), SBP (P=0.011) and serum creatinine (P<0.001) were independently associated with cystatin C. Furthermore, we found that cystatin C was independently associated with the occurrence of DKA in T1DM patients (OR=0.004, 95% CI: 0.000-0.079, P<0.001). CONCLUSIONS Cystatin C was decreased in T1DM patients with DKA and was found to be an independent predictor of the occurrence of DKA in T1DM patients. The reduction in cystatin C levels might be significantly connected with acute events.
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Affiliation(s)
- Yiping Cheng
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Chao Xu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Sichao Wang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Lin Hou
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Qingbo Guan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xinli Zhou
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China - .,Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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13
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Serum cystatin-c as predictive factor of preeclampsia: A meta-analysis of 27 observational studies. Pregnancy Hypertens 2019; 16:97-104. [PMID: 31056166 DOI: 10.1016/j.preghy.2019.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 01/27/2019] [Accepted: 03/11/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Serum cystatin-c is a protein that is filtered freely through the glomerulus and reabsorbed and degraded by proximal tubular cells and can be used as a biomarker of renal function. Its levels rise during the third trimester and decrease in the postpartum period. The purpose of the present meta-analysis is to assess the performance of serum cystatin-c for the prediction of preeclampsia. DESIGN AND METHODS We used the Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar. We selected all observational studies (both prospective and retrospective) that investigated the accuracy of cystatin-c in predicting preeclampsia. Statistical meta-analysis was performed with the RevMan 5.3 and Stata/IC 13.0 software, using hierarchical models to develop the SROC curve. RESULTS The quantitative synthesis was based in 27 studies with a total number of 2,320 women. Serum cystatin-c levels were higher in preeclamptic women compared to healthy pregnant controls (MD: 0.40 mg/l, 95% CI [0.33, 0.46]). The pooled sensitivity of serum cystatin-c for the prediction of preeclampsia was 0.85 (95% CI [0.79-0.89]) and the pooled specificity 0.84 (95% CI [0.77-0.90]. Fagan's nomogram indicated that the post-test probability increased to 14% (positive test) and decreased to 1% (negative test), when the pre-test probability was set at 3%. CONCLUSIONS According to the findings of our study serum cystatin-c seems to be a promising biomarker for the detection of preeclampsia during the third trimester of pregnancy. Therefore, its implementation in future predictive models in the field is recommended.
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14
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Cystatin C for predicting all-cause mortality and rehospitalization in patients with heart failure: a meta-analysis. Biosci Rep 2019; 39:BSR20181761. [PMID: 30643006 PMCID: PMC6361773 DOI: 10.1042/bsr20181761] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/09/2018] [Accepted: 11/27/2018] [Indexed: 12/23/2022] Open
Abstract
Circulating cystatin C (cys-C/CYC) has been identified as an independent predictor of all-cause mortality in patients with coronary artery disease and the general population. This meta-analysis aimed to systematically evaluate the association between elevated cys-C level and all-cause mortality and rehospitalization risk amongst patients with heart failure (HF). PubMed and Embase databases were searched until December 2017. All prospective observational studies that reported a multivariate-adjusted risk estimate of all-cause mortality and/or rehospitalization for the highest compared with lowest cys-C level in HF patients were included. Ten prospective studies involving 3155 HF patients were included. Meta-analysis indicated that the highest compared with lowest cys-C level was associated with an increased risk of all-cause mortality (hazard ratio (HR): 2.33; 95% confidence intervals (CI): 1.67-3.27; I2 = 75.0%, P<0.001) and combination of mortality/rehospitalization (HR: 2.06; 95%CI: 1.58-2.69; I2 = 41.6%, P=0.181). Results of stratified analysis indicated that the all-cause mortality risk was consistently found in the follow-up duration, cys-C cut-off value or type of HF subgroup. Elevated cys-C level is possibly associated with an increased risk of all-cause mortality and rehospitalization in HF patients. This increased risk is probably independent of creatinine or estimated glomerular filtration rate (eGFR).
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15
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Kim HJ, Byun DW, Suh K, Yoo MH, Park HK. Association between Serum Cystatin C and Vascular Complications in Type 2 Diabetes Mellitus without Nephropathy. Diabetes Metab J 2018; 42:513-518. [PMID: 30398035 PMCID: PMC6300438 DOI: 10.4093/dmj.2018.0006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 08/09/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Recent studies have correlated serum cystatin C (CysC) with vascular complications, but few studies have investigated this correlation in diabetes patients without nephropathy. This study aimed to evaluate if higher serum CysC levels increase the risk for vascular complications in type 2 diabetes mellitus patients with normal renal function or mild renal impairment. METHODS A total of 806 consecutive patients with type 2 diabetes mellitus who were admitted to the diabetes center of Soonchunhyang University Hospital for blood glucose control were retrospectively reviewed. Patients with nephropathy were excluded. Subjects were categorized into quartiles of serum CysC levels (Q1, ≤0.65 mg/L; Q2, 0.66 to 0.79 mg/L; Q3, 0.80 to 0.94 mg/L; and Q4, ≥0.95 mg/L). RESULTS The proportion of patients with diabetic retinopathy (DR) (P for trend <0.001), coronary heart disease (CHD) (P for trend <0.001), and stroke (P for trend <0.001) increased across the serum CysC quartiles. After adjustment for confounding factors, the highest serum CysC level remained a significant risk factor for DR (odds ratio [OR], 1.929; 95% confidence interval [CI], 1.007 to 4.144; P=0.040). Compared with Q1, a significant positive association was observed between serum CysC and CHD in Q2 (OR, 7.321; 95% CI, 1.114 to 48.114; P=0.012), Q3 (OR, 6.027; 95% CI, 0.952 to 38.161; P=0.020), and Q4 (OR, 8.122; 95% CI, 1.258 to 52.453; P=0.007). No associations were observed between CysC and stroke after additional adjustment for confounding variables. CONCLUSION Serum CysC levels are independently associated with DR and CHD, suggesting that CysC may be useful for identifying type 2 diabetes mellitus patients without nephropathy who are at high risk for vascular complications.
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Affiliation(s)
- Hye Jeong Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Dong Won Byun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Kyoil Suh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Myung Hi Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hyeong Kyu Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
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16
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Ma J, Wu Z, Zha X, Zhu X, Li W, Jiang M, Wang S, Wu S, Wen Y. The combined effect of serum cystatin C and dyslipidemia on hypertension in a large health check-up population in China. Clin Exp Hypertens 2018; 41:702-707. [PMID: 30497286 DOI: 10.1080/10641963.2018.1545845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE: Some studies have reported that both serum cystatin C (Cys C) and dyslipidemia are independently associated with hypertension. However, the combined effect of the two factors is still unknown. The present study was aimed at investigating the effect of Cys C combined with dyslipidemia on hypertension in a large health check-up population in China. METHODS: A total of 203 233 health check-up subjects from January 2011 to July 2016 were recruited into this cross-sectional study. A multivariate logistic regression model was used to evaluate the combined effect of Cys C and dyslipidemia on hypertension.RESULTS: In univariate analysis, Cys C, high-density lipoprotein cholesterol, low-density lipoprotein, total cholesterol, and triglycerides were independently correlated with hypertension (p < 0.001). A concentration-dependent combined effect of serum Cys C and dyslipidemia on hypertension was observed in multivariate regression analysis. When compared with Cys C of <0.82 mg/L, the risk of hypertension in Cys C of <0.82 mg/L with dyslipidemia, Cys C of 0.82-0.94 mg/L with dyslipidemia, Cys C of 0.94-1.08 mg/L with dyslipidemia, and Cys C of ≥1.08 mg/L with dyslipidemia was increased 1.946 (95% confidence interval [CI]: 1.827-2.074), 1.973 (95% CI: 1.864-2.088), 2.047 (95% CI: 1.941-2.158), and 2.038 (95% CI: 1.937-2.143) folds, respectively, after adjustment.CONCLUSION: There was an association between hypertension and the combined effect of Cys C with dyslipidemia.
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Affiliation(s)
- Jun Ma
- School of Laboratory Medicine, Wannan Medical College, Wuhu City, Anhui Province, China
| | - Zewei Wu
- School of Laboratory Medicine, Wannan Medical College, Wuhu City, Anhui Province, China
| | - Xiaojuan Zha
- The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital
| | - Xinying Zhu
- School of Laboratory Medicine, Wannan Medical College, Wuhu City, Anhui Province, China
| | - Wenbo Li
- School of Clinical Medicine, Wannan Medical College, Wuhu City, Anhui Province, China
| | - Mingfei Jiang
- School of Laboratory Medicine, Wannan Medical College, Wuhu City, Anhui Province, China
| | - Shuyi Wang
- School of Laboratory Medicine, Wannan Medical College, Wuhu City, Anhui Province, China
| | - Shouzhi Wu
- School of Public Foundation, Wannan Medical College, Wuhu City, Anhui Province, China
| | - Yufeng Wen
- School of Laboratory Medicine, Wannan Medical College, Wuhu City, Anhui Province, China
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17
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Danesh A, Inglis HC, Abdel-Mohsen M, Deng X, Adelman A, Schechtman KB, Heitman JW, Vilardi R, Shah A, Keating SM, Cohen MJ, Jacobs ES, Pillai SK, Lacroix J, Spinella PC, Norris PJ. Granulocyte-Derived Extracellular Vesicles Activate Monocytes and Are Associated With Mortality in Intensive Care Unit Patients. Front Immunol 2018; 9:956. [PMID: 29867942 PMCID: PMC5951932 DOI: 10.3389/fimmu.2018.00956] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 04/17/2018] [Indexed: 11/13/2022] Open
Abstract
To understand how extracellular vesicle (EV) subtypes differentially activate monocytes, a series of in vitro studies were performed. We found that plasma-EVs biased monocytes toward an M1 profile. Culturing monocytes with granulocyte-, monocyte-, and endothelial-EVs induced several pro-inflammatory cytokines. By contrast, platelet-EVs induced TGF-β and GM-CSF, and red blood cell (RBC)-EVs did not activate monocytes in vitro. The scavenger receptor CD36 was important for binding of RBC-EVs to monocytes, while blockade of CD36, CD163, CD206, TLR1, TLR2, and TLR4 did not affect binding of plasma-EVs to monocytes in vitro. To identify mortality risk factors, multiple soluble factors and EV subtypes were measured in patients' plasma at intensive care unit admission. Of 43 coagulation factors and cytokines measured, two were significantly associated with mortality, tissue plasminogen activator and cystatin C. Of 14 cellular markers quantified on EVs, 4 were early predictors of mortality, including the granulocyte marker CD66b. In conclusion, granulocyte-EVs have potent pro-inflammatory effects on monocytes in vitro. Furthermore, correlation of early granulocyte-EV levels with mortality in critically ill patients provides a potential target for intervention in management of the pro-inflammatory cascade associated with critical illness.
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Affiliation(s)
- Ali Danesh
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Heather C Inglis
- Blood Systems Research Institute, San Francisco, CA, United States
| | - Mohamed Abdel-Mohsen
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Xutao Deng
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Avril Adelman
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Kenneth B Schechtman
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.,Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - John W Heitman
- Blood Systems Research Institute, San Francisco, CA, United States
| | - Ryan Vilardi
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Avani Shah
- Blood Systems Research Institute, San Francisco, CA, United States
| | - Sheila M Keating
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Mitchell J Cohen
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Evan S Jacobs
- Blood Systems Research Institute, San Francisco, CA, United States
| | - Satish K Pillai
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Jacques Lacroix
- Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montreal, QC, Canada
| | - Philip C Spinella
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Philip J Norris
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States.,Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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18
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Corsonello A, Pedone C, Bandinelli S, Ferrucci L, Antonelli Incalzi R. Predicting survival of older community-dwelling individuals according to five estimated glomerular filtration rate equations: The InChianti study. Geriatr Gerontol Int 2018; 18:607-614. [PMID: 29356245 DOI: 10.1111/ggi.13225] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/21/2017] [Accepted: 11/13/2017] [Indexed: 11/30/2022]
Abstract
AIMS There is uncertainty about which estimated glomerular filtration rate eGFR equation to use in older people with respect to the prediction of prognosis. Our aim was: (i) to compare the discriminative capacity of eGFR estimated by different equations with respect to all-cause mortality; and (ii) to identify the eGFR threshold at which the risk of mortality starts to increase for each equation. METHODS We used data from 828 community-dwelling older adults aged >65 years enrolled in the InCHIANTI study. The outcome measure was all-cause mortality at 9 years. GFR was estimated by five different equations: Chronic Kidney Disease Epidemiological Collaboration (creatinine equation [CKD-EPIcre ], and creatinine and cystatin C equation [CKD-EPIcre-cys ]), Berlin Initiative Study (BIScre and BIScre-cys ) and full age spectrum. Sensitivity, specificity, areas under receiver operating curve (AUC) and C-statistics were used to compare their predictive capacity. RESULTS The best mix of sensitivity, specificity, AUC and C-statistic value in predicting mortality was observed with BIS equations. BIScre (AUC 0.65, 95% CI 0.61-0.69) outperformed both CKD-EPIcre (AUC 0.60, 95% CI 0.56-0.64; P = 0.005) and full age spectrum (AUC 0.63, 95% CI 0.59-0.67; P = 0.002) in terms of predictivity. Similarly, BIScre-cys (AUC 0.67, 95% CI 0.63-0.71) outperformed CKD-EPIcre-cys (AUC 0.63, 95% CI 0.59-0.67; P = 0.01). AUC obtained with equations also including cystatin C were not significantly different compared with their creatinine-based counterparts. The risk of long-term mortality began to increase at under 65.6 mL/min/1.73 m2 for CKD-EPIcre-cys , 60.5 for CKD-EPIcre , 60 for BIScre-cys , 56.3 for BIScre and 55.2 for full age spectrum. CONCLUSIONS The BIS equation discriminates the risk of all-cause mortality better than other equations in older community-dwelling individuals. The eGFR threshold under which mortality starts to increase could change as a function of the equation used. Geriatr Gerontol Int 2018; 18: 607-614.
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Affiliation(s)
- Andrea Corsonello
- Unit of Geriatric Pharmacoepidemiology, Italian National Research Center on Aging, Cosenza, Italy
| | - Claudio Pedone
- Unit of Geriatric Medicine, University Campus Biomedico, Rome, Italy
| | | | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Raffaele Antonelli Incalzi
- Unit of Geriatric Medicine, University Campus Biomedico, Rome, Italy.,'Cittadella della Carità' Foundation, Taranto, Italy
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Reference Intervals for Non-Fasting CVD Lipids and Inflammation Markers in Pregnant Indigenous Australian Women. Healthcare (Basel) 2017; 5:healthcare5040072. [PMID: 29036887 PMCID: PMC5746706 DOI: 10.3390/healthcare5040072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 10/06/2017] [Accepted: 10/08/2017] [Indexed: 12/14/2022] Open
Abstract
Indigenous Australians experience high rates of cardiovascular disease (CVD). The origins of CVD may commence during pregnancy, yet few serum reference values for CVD biomarkers exist specific to the pregnancy period. The Gomeroi gaaynggal research project is a program that undertakes research and provides some health services to pregnant Indigenous women. Three hundred and ninety-nine non-fasting samples provided by the study participants (206 pregnancies and 175 women) have been used to construct reference intervals for CVD biomarkers during this critical time. A pragmatic design was used, in that women were not excluded for the presence of chronic or acute health states. Percentile bands for non-linear relationships were constructed according to the methods of Wright and Royston (2008), using the xriml package in StataIC 13.1. Serum cholesterol, triglycerides, cystatin-C and alkaline phosphatase increased as gestational age progressed, with little change seen in high-sensitivity C-Reactive Protein and γ glutamyl transferase. Values provided in the reference intervals are consistent with findings from other research projects. These reference intervals will form a basis with which future CVD biomarkers for pregnant Indigenous Australian women can be compared.
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Serum cystatin C is associated with kidney function but not with cardiovascular risk factors or subclinical atherosclerosis in patients with Systemic Lupus Erythematosus. Clin Rheumatol 2017; 36:2709-2717. [DOI: 10.1007/s10067-017-3837-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 09/05/2017] [Accepted: 09/08/2017] [Indexed: 12/16/2022]
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