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Song X, Xiong L, Guo T, Chen X, Zhang P, Zhang X, Liang Z. Cystatin C Is a Predictor for Long-Term, All-Cause, and Cardiovascular Mortality in US Adults With Metabolic Syndrome. J Clin Endocrinol Metab 2024; 109:2905-2919. [PMID: 38597157 DOI: 10.1210/clinem/dgae225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This study examined the relationship between cystatin C (CysC) levels and all-cause, cardiovascular disease (CVD), and cancer mortality in US metabolic syndrome (MetS) patients. METHODS The 1999-2002 National Health and Nutrition Examination Survey (NHANES) prospective cohort research included 1980 MetS participants. To assess CysC levels and all-cause, CVD, and cancer mortality, fitted curves, Kaplan-Meier survival curves, Cox regression analysis, and receiver operating characteristic curves were performed. RESULTS During a mean follow-up of 15.3 ± 5.4 years, a total of 819 deaths occurred. The fitted and Kaplan-Meier survival curves revealed that greater CysC levels were linked to higher all-cause, CVD, and cancer mortality rates (P < .05). After adjusting for variables, CysC level was associated with all-cause, CVD, and cancer mortality at 1.63 (1.42-1.88), 1.53 (1.19-1.95), and 1.53 (1 ∼ 2.32), respectively (P < .05). Tertile models showed consistent results: high CysC Tertile participants showed higher risk of all-cause mortality (HR 1.87; 1.43-2.45), CVD mortality (HR 1.97, 1.15 ∼ 3.38), and cancer mortality (HR 1.72, 1.01 ∼ 2.91) compared to those in the lowest tertile (P < .05). Subgroup studies by sex and other characteristics confirmed the findings. CysC demonstrated the higher predictive efficacy across mortality outcomes, followed by eGFR, outperforming urea nitrogen, creatinine, uric acid, and C-reactive protein. CysC alone exhibited substantial predictive value for all-cause (AUC 0.773; P < .05) and CVD mortality (AUC 0.726; P < .05). Combining CysC with age enhanced predictive value for all-cause mortality to 0.861 and CVD mortality to 0.771 (P < .05). CONCLUSION MetS patients with elevated CysC levels have a higher risk of all-cause, CVD, and cancer death. CysC may predict MetS all-cause and CVD mortality.
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Affiliation(s)
- Xiaoying Song
- Medical Department, Ganzhou People's Hospital, Ganzhou, Jiangxi Province, 341000, China
| | - Lijiao Xiong
- Department of Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518000, China
| | - Tianting Guo
- Ganzhou Hospital of Guangdong Provincial People's Hospital (Ganzhou Municipal Hospital), Ganzhou, Jiangxi Province, 341000, China
| | - Xue Chen
- Department of Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518000, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518000, China
| | - Pinjun Zhang
- Gannan Medical University, Ganzhou, Jiangxi Province, 341000, China
| | - Xiaoan Zhang
- Ganzhou Hospital of Guangdong Provincial People's Hospital (Ganzhou Municipal Hospital), Ganzhou, Jiangxi Province, 341000, China
| | - Zhen Liang
- Department of Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518000, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518000, China
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Chen JH, Chen JY, Chen YC, Li WC. Sex difference in the association between creatinine-to-cystatin C ratio and metabolic syndrome among Chinese adults. Front Endocrinol (Lausanne) 2024; 15:1389295. [PMID: 39205686 PMCID: PMC11349525 DOI: 10.3389/fendo.2024.1389295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/15/2024] [Indexed: 09/04/2024] Open
Abstract
Background Metabolic syndrome (MetS), characterized by central obesity, insulin resistance, dyslipidemia, and hypertension, affects 20-25% of the global population. The creatinine-to-cystatin C ratio (CCR) is an indicator of skeletal muscle mass. While CCR may play a role in MetS development, sex differences in these associations are not fully understood. Therefore, this study aimed to investigate how CCR levels are associated with MetS in a Chinese adult population, focusing on possible sex disparities. Method We conducted a retrospective cross-sectional analysis of 9,376 adults from Xiamen Chang Gung Hospital between 2014 to 2016. We examined the relationship between CCR and MetS, adjusting for cardiometabolic risk factors. Results The prevalence of MetS was 24.7% in males and 18.0% in females. Interestingly, we observed significant sex differences in the association between CCR quartiles and MetS. Females in the lowest CCR quartile had a significantly higher risk of MetS (odds ratio=1.84). Receiver operating characteristic curve analysis revealed acceptable diagnostic power of CCR for MetS in females (area under the curve=0.65) but not in males. Conclusion Our findings suggest that CCR is an independent risk factor for MetS in females, highlighting the importance of sex-specific assessments when evaluating MetS risk.
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Affiliation(s)
- Jo-Hsuan Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Health Management, Xiamen Chang-Gung Hospital, Xiamen, China
| | - Yi-Chuan Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Wen-Cheng Li
- Department of Family Medicine, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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de Girolamo G, Andreassen OA, Bauer M, Brambilla P, Calza S, Citerà N, Corcoy R, Fagiolini A, Garcia-Argibay M, Godin O, Klingler F, Kobayashi NF, Larsson H, Leboyer M, Matura S, Martinelli A, De la Peña-Arteaga V, Poli R, Reif A, Ritter P, Rødevand LN, Magno M, Caselani E. Medical comorbidities in bipolar disorder (BIPCOM): clinical validation of risk factors and biomarkers to improve prevention and treatment. Study protocol. Int J Bipolar Disord 2024; 12:15. [PMID: 38703295 PMCID: PMC11069492 DOI: 10.1186/s40345-024-00337-8] [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: 12/07/2023] [Accepted: 04/24/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND BIPCOM aims to (1) identify medical comorbidities in people with bipolar disorder (BD); (2) examine risk factors and clinical profiles of Medical Comorbidities (MC) in this clinical group, with a special focus on Metabolic Syndrome (MetS); (3) develop a Clinical Support Tool (CST) for the personalized management of BD and medical comorbidities. METHODS The BIPCOM project aims to investigate MC, specifically MetS, in individuals with BD using various approaches. Initially, prevalence rates, characteristics, genetic and non-genetic risk factors, and the natural progression of MetS among individuals with BD will be assessed by analysing Nordic registers, biobanks, and existing patient datasets from 11 European recruiting centres across 5 countries. Subsequently, a clinical study involving 400 participants from these sites will be conducted to examine the clinical profiles and incidence of specific MetS risk factors over 1 year. Baseline assessments, 1-year follow-ups, biomarker analyses, and physical activity measurements with wearable biosensors, and focus groups will be performed. Using this comprehensive data, a CST will be developed to enhance the prevention, early detection, and personalized treatment of MC in BD, by incorporating clinical, biological, sex and genetic information. This protocol will highlight the study's methodology. DISCUSSION BIPCOM's data collection will pave the way for tailored treatment and prevention approaches for individuals with BD. This approach has the potential to generate significant healthcare savings by preventing complications, hospitalizations, and emergency visits related to comorbidities and cardiovascular risks in BD. BIPCOM's data collection will enhance BD patient care through personalized strategies, resulting in improved quality of life and reduced costly interventions. The findings of the study will contribute to a better understanding of the relationship between medical comorbidities and BD, enabling accurate prediction and effective management of MetS and cardiovascular diseases. TRIAL REGISTRATION ISRCTN68010602 at https://www.isrctn.com/ISRCTN68010602 . Registration date: 18/04/2023.
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Affiliation(s)
- Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Ole A Andreassen
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Nicholas Citerà
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rosa Corcoy
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029, Madrid, Spain
| | - Andrea Fagiolini
- Department of Molecular and Developmental Medicine, Division of Psychiatry, University of Siena School of Medicine, Siena, Italy
| | - Miguel Garcia-Argibay
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Ophélia Godin
- Fondation FondaMental, Créteil, France
- Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France
| | - Florian Klingler
- Deutsche Gesellschaft Für Bipolare Störungen (DGBS) E.V, Hamburg, Germany
| | - Nene F Kobayashi
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
| | - Henrik Larsson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France
- Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
| | - Alessandra Martinelli
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Víctor De la Peña-Arteaga
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029, Madrid, Spain
| | - Roberto Poli
- Department of Mental Health, Psychiatric Unit of Cremona General Hospital, Azienda Ospedaliera di Cremona, Cremona, Italy
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - Linn N Rødevand
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Marta Magno
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elisa Caselani
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Keddis MT, Howard MR, Galapia L, Barreto EF, Zhang N, Butterfield RJ, Rule AD. GFR estimated with creatinine rather than cystatin C is more reflective of the true risk of adverse outcomes with low GFR in kidney transplant recipients. Nephrol Dial Transplant 2023; 38:1898-1906. [PMID: 36646435 PMCID: PMC10387404 DOI: 10.1093/ndt/gfad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Serum cystatin C-based estimated glomerular filtration rate (eGFRcys) generally associates with clinical outcomes better than serum creatinine-based eGFR (eGFRcr) despite similar precision in estimating measured GFR (mGFR). We sought to determine whether the risk of adverse outcomes with eGFRcr or eGFRcys was via GFR alone or also via non-GFR determinants among kidney transplant recipients. METHODS Consecutive adult kidney transplant recipients underwent a standardized GFR assessment during a routine follow-up clinic visit between 2011 and 2013. Patients were followed for graft failure or the composite outcome of cardiovascular (CV) events or mortality through 2020. The risk of these events by baseline mGFR, eGFRcr and eGFRcys was assessed unadjusted, adjusted for mGFR and adjusted for CV risk factors. RESULTS There were 1135 recipients with a mean baseline mGFR of 55.6, eGFRcr of 54.8 and eGFRcys of 46.8 ml/min/1.73 m2 and a median follow-up of 6 years. Each 10 ml/min/1.73 m2 decrease in mGFR, eGFRcr or eGFRcys associated with graft failure [hazard ratio (HR) 1.79, 1.68 and 2.07, respectively; P < .001 for all) and CV events or mortality outcome (HR 1.28, 1.19 and 1.43, respectively; P < .001 for all). After adjusting for mGFR, eGFRcys associated with graft failure (HR 1.57, P < .001) and CV events or mortality (HR 1.49, P < .001), but eGFRcr did not associate with either. After further adjusting for CV risk factors, risk of these outcomes with lower eGFRcys was attenuated. CONCLUSION eGFRcr better represents the true relationship between GFR and outcomes after kidney transplantation because it has less non-GFR residual association. Cystatin C is better interpreted as a nonspecific prognostic biomarker than is eGFR in the kidney transplant setting.
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Affiliation(s)
- Mira T Keddis
- Division of Nephrology, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Leyton Galapia
- Division of Nephrology, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Nan Zhang
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Andrew D Rule
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
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Serum Cystatin-C is linked to increased prevalence of diabetes and higher risk of mortality in diverse middle-aged and older adults. PLoS One 2022; 17:e0270289. [PMID: 36094936 PMCID: PMC9467319 DOI: 10.1371/journal.pone.0270289] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 06/06/2022] [Indexed: 01/13/2023] Open
Abstract
Objective Type 2 Diabetes Mellitus (henceforth diabetes) affects roughly 35 million individuals in the US and is a major risk factor for cardiovascular and kidney disease. Serum Cystatin-C is used to monitor renal function and detect kidney damage. Recent research has focused on linking Cystatin-C to cardiovascular risk and disease, but most findings focus on small sample sizes and generalize poorly to diverse populations, thus limiting epidemiological inferences. The aim of this manuscript is to study the association between Cystatin-C, diabetes, and mortality and test for possible sex or racial/ethnic background modifications in these relationships. Methods We analyzed 8-years of biennial panel data from Health and Retirement Study participants 50-years and older who self-identified as White (unweighted N (uN) = 5,595), Black (uN = 867), or Latino (uN = 565) for a total of uN = 7,027 individuals. We modeled diabetes and death over 8-years as function of baseline Cystatin-C (log transformed) adjusting for covariates and tested modifications in associations by race/ethnic background and sex. Results Mean log Cystatin-C at visit 1 was 0.03±0.32 standard deviation. A 10% increase in Cystatin-C levels was associated with 13% increased relative risk of diabetes at baseline (11% and 9% by years 4 and 8). A 10% increase in Cystatin-C was highly associated with increased relative risk of death (28% and 31% by years 4 and 8). These associations were present even after adjusting for possible confounders and were not modified by sex or racial/ethnic background. Conclusion Despite differential risks for diabetes and mortality by racial/ethnic groups, Cystatin-C was equally predictive of these outcomes across groups. Cystatin-C dysregulations could be used as a risk indicator for diabetes and as a warning sign for accelerated risk of mortality.
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Biomarkers in metabolic syndrome. Adv Clin Chem 2022; 111:101-156. [DOI: 10.1016/bs.acc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Huo YX, Wei W, Liu Y, Ma YN, Tao JM, Wang NN, Li XF, Chen X. Serum Cystatin C Levels Are Associated With Obesity in Adolescents Aged 14-17 Years. Front Endocrinol (Lausanne) 2022; 13:816201. [PMID: 35185798 PMCID: PMC8854751 DOI: 10.3389/fendo.2022.816201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The association between serum cystatin C levels and obesity has not been fully explored in adolescents. This study aimed to explore the association between serum cystatin C levels and obesity in adolescents of different sexes. METHODS We conducted a cross-sectional study including 481 adolescents aged 14-17 years. Cystatin C level was measured by immunoassay. Health examinations data, biochemical parameters, and questionnaire information were collected. The restricted cubic spline model analyzed the association between cystatin C levels and obesity in boys and girls. RESULTS Boys exhibited significantly higher cystatin C levels than girls, with a mean level of 0.97 ± 0.10 mg/L in boys and 0.86 ± 0.09 mg/L in girls (P < 0.001). The restricted cubic spline model suggested that low or high cystatin C levels were associated with an increased risk of obesity in boys, whereas only higher cystatin C levels were associated with an increased risk of obesity in girls. CONCLUSIONS A U-shaped correlation was observed between serum cystatin C levels and the risk of obesity in boys. However, in girls, the risk of obesity showed a trend of initially increase and then decrease with increasing cystatin C levels. Longitudinal studies should be conducted to further investigate the diagnostic potential of cystatin C in the progression of early obesity in adolescents of different sexes.
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Affiliation(s)
- Ying-Xiang Huo
- Department of Epidemiology, School of Public Health, Dalian Medical University, Dalian, China
| | - Wei Wei
- Department of Neurosurgery, Affiliated Dalian Municipal Central Hospital, Dalian Medical University, Dalian, China
| | - Yang Liu
- Institute of Health Science, China Medical University, Shenyang, China
| | - Ya-Nan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Jun-Min Tao
- Department of Epidemiology, School of Public Health, Dalian Medical University, Dalian, China
| | - Ning-Ning Wang
- Department of Food Nutrition and Safety, School of Public Health, Dalian Medical University, Dalian, China
| | - Xiao-Feng Li
- Department of Epidemiology, School of Public Health, Dalian Medical University, Dalian, China
| | - Xin Chen
- Department of Epidemiology, School of Public Health, Dalian Medical University, Dalian, China
- *Correspondence: Xin Chen,
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Hassannejad R, Sharrouf H, Haghighatdoost F, Kirk B, Amirabdollahian F. Diagnostic Power of Circulatory Metabolic Biomarkers as Metabolic Syndrome Risk Predictors in Community-Dwelling Older Adults in Northwest of England (A Feasibility Study). Nutrients 2021; 13:nu13072275. [PMID: 34209146 PMCID: PMC8308366 DOI: 10.3390/nu13072275] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.
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Affiliation(s)
- Razieh Hassannejad
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran; (R.H.); (F.H.)
| | - Hamsa Sharrouf
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran; (R.H.); (F.H.)
| | - Ben Kirk
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Furlong Road, St. Albans, Melbourne, VIC 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St. Albans, Melbourne, VIC 3201, Australia
| | - Farzad Amirabdollahian
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
- Correspondence:
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Aghamollaei H, Parvin S, Shahriary A. Review of proteomics approach to eye diseases affecting the anterior segment. J Proteomics 2020; 225:103881. [PMID: 32565161 DOI: 10.1016/j.jprot.2020.103881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/08/2020] [Accepted: 06/16/2020] [Indexed: 01/12/2023]
Abstract
Visual impairment and blindness is a major health burden worldwide, and major ocular diseases causing visual impairment pertain to the anterior segment of the eye. Anterior segment ocular diseases are common, yet complex entities. Although many treatment options and surgical techniques are available for these ailments, the underlying cause and pathogenesis is still unclear. Finding ways to fundamentally treat these patients and rectify the underlying dysregulations leading to the disease may help cure patients completely without major complications. Proteomics approaches are a novel way to distinguish dysregulated proteins in a variety of biological tissues in a hypothesis-free manner, thus helping to find the responsible pathways leading to a certain disease. The aim of the current study is to review the available knowledge in scientific literature regarding the proteomics studies done on anterior segment eye diseases and suggest potential clinical implications to exploit the results of these studies. SIGNIFICANCE: Anterior segment ocular diseases are responsible for a major proportion of visual impairment and blindness worldwide. Although ophthalmologists have several treatment options that can alleviate or control the progression of these diseases, no definite cure is available for most of them. Moreover, because these diseases are progressive, prompt diagnosis is of utmost important. Proteomics studies enable us to identify and quantify the dysregulated proteins in a biological specimen in a hypothesis-free manner. Understanding the dysregulated protein pathways shines a light on the pathogenesis of the disease. Moreover, these dysregulated proteins may act as biomarkers to help in diagnosis and treatment follow-up. Hence, in this article we sought out to review the available scientific literature regarding the proteomics studies of anterior segment ocular diseases and to identify potential applications of proteomic studies in clinic.
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Affiliation(s)
- Hossein Aghamollaei
- Chemical Injuries Research Center, Systems biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Shahram Parvin
- Chemical Injuries Research Center, Systems biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alireza Shahriary
- Chemical Injuries Research Center, Systems biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Huang X, Jiang X, Wang L, Liu Z, Wu Y, Gao P, Lian X, Hua F. Serum Cystatin C and Arterial Stiffness in Middle-Aged and Elderly Adults without Chronic Kidney Disease: A Population-Based Study. Med Sci Monit 2019; 25:9207-9215. [PMID: 31793519 PMCID: PMC6909910 DOI: 10.12659/msm.916630] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cystatin C is a protease inhibitor that is increased in the serum of patients with chronic kidney disease (CKD) and is associated with an increased risk of developing cardiovascular disease (CVD). This study aimed to evaluate the association between serum levels of cystatin C and arterial stiffness, associated with dyslipidemia, obesity, and increased pulse pressure, in middle-aged and elderly individuals without CKD in a population in China. MATERIAL AND METHODS A cross-sectional population-based study included 1,138 patients aged ≥40 years without CKD, defined as an estimated glomerular filtration rate measured by serum creatinine (eGFRSCr) ≥60 ml/min/1.73 m². Study participants provided clinical details, including height and weight, and blood samples for serum measurements of cystatin C and lipid profiles and completed a clinical questionnaire. Pulse pressure was calculated as the mean systolic pressure (SBP) minus the diastolic pressure (DBP). Data underwent multivariate logistic regression analysis. RESULTS An increase in serum levels of cystatin C was associated with an increased risk of arterial stiffness. Each standard deviation in the increase of cystatin C resulted in a 22% increased risk of dyslipidemia, a 27% increased risk of obesity, and a 24% increased risk of increased pulse pressure, after adjusting for confounders. These associations were further confirmed in a sensitivity analysis by excluding participants with hypertension, diabetes, and patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). CONCLUSIONS In middle-aged and elderly individuals without CKD, arterial stiffness determined by obesity, dyslipidemia and increased pulse pressure, was significantly associated with increased serum levels of cystatin C.
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Affiliation(s)
- Xiaolin Huang
- Department of Endocrine and Metabolic Diseases, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Xiaohong Jiang
- Department of Endocrine and Metabolic Diseases, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Long Wang
- Department of Endocrine and Metabolic Diseases, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Zhenyu Liu
- Department of Endocrine and Metabolic Diseases, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Yang Wu
- Department of Endocrine and Metabolic Diseases, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Pei Gao
- Department of Endocrine and Metabolic Diseases, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Xuegan Lian
- Department of Endocrine and Metabolic Diseases, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Fei Hua
- Department of Endocrine and Metabolic Diseases, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
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Chen X, Bhuiyan I, Kuja-Halkola R, Magnusson PKE, Svensson P. Genetic and Environmental Influences on the Correlations between Traits of Metabolic Syndrome and CKD. Clin J Am Soc Nephrol 2019; 14:1590-1596. [PMID: 31506278 PMCID: PMC6832046 DOI: 10.2215/cjn.11971018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 07/31/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Metabolic syndrome is a cluster of risk factors associated with CKD. By studying the genetic and environmental influences on how traits of metabolic syndrome correlate with CKD, the understanding of the etiological relationships can be improved. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS From the population-based TwinGene project within the Swedish Twin Registry, 4721 complete twin pairs (9442 European ancestry participants) were included in this cross-sectional twin study. Metabolic syndrome-related continuous traits were measured, and the binary components as well as the status of metabolic syndrome were defined according to the National Cholesterol Education Program-Adult Treatment Panel III. The eGFR was calculated by cystatin C-based equations from the CKD epidemiology collaboration group, and CKD was defined by eGFR<60 ml/min per 1.73 m2. Genetic and environmental contributions to the correlations between traits of metabolic syndrome and CKD were estimated by using twin-based bivariate structural equation models. RESULTS The correlation between metabolic syndrome and eGFR-defined CKD was 0.16 (95% confidence interval [95% CI], 0.12 to 0.20), out of which 51% (95% CI, 12% to 90%) was explained by genes, whereas 15% (95% CI, 0% to 42%) and 34% (95% CI, 16% to 52%) was explained by the shared and nonshared environment, respectively. The genetic and environmental correlations between metabolic syndrome and CKD were 0.29 (95% CI, 0.07 to 0.51) and 0.27 (95% CI, 0.13 to 0.41), respectively. For the correlation between abdominal obesity and eGFR, 69% (95% CI, 10% to 100%) was explained by genes and 23% (95% CI, 5% to 41%) was explained by environment. The genetic correlation between abdominal obesity and eGFR was -0.30 (95% CI, -0.54 to -0.06), whereas the environmental correlation was -0.14 (95% CI, -0.22 to -0.06). CONCLUSIONS Both genes and environment contribute to the correlation between metabolic syndrome and eGFR-defined CKD. The genetic contribution is particularly important to the correlation between abdominal obesity and eGFR.
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Affiliation(s)
- Xu Chen
- Department of Central Laboratory and .,Department of Medical Epidemiology and Biostatistics and.,Department of Medicine, Solna and
| | | | | | | | - Per Svensson
- Department of Clinical Science and Education, Karolinska Institute; and.,Department of Cardiology, Södersjukhuset, Stockholm, Sweden
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Mao Q, Zhao N, Wang Y, Li Y, Xiang C, Li L, Zheng W, Xu S, Zhao XH. Association of Cystatin C with Metabolic Syndrome and Its Prognostic Performance in Non-ST-Segment Elevation Acute Coronary Syndrome with Preserved Renal Function. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8541402. [PMID: 31317040 PMCID: PMC6601472 DOI: 10.1155/2019/8541402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 04/11/2019] [Indexed: 12/03/2022]
Abstract
OBJECTIVE The underlying mechanisms by which cystatin C affects cardiovascular disease (CVD) are not very clear. Metabolic syndrome (MetS) is a cluster of risk factors that increase the risk of CVD. Here, we aimed to investigate the association of cystatin C with metabolic syndrome and cardiovascular outcomes in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) with preserved renal function. METHODS In total, 422 NSTE-ACS patients with preserved renal function were enrolled to examine the association of cystatin C with MetS. MetS was defined based on the NCEP-ATP-III guidelines. Major adverse cardiovascular events (MACEs) were also evaluated, which included cardiac death, nonfatal myocardial infarction (MI), target vessel revascularization (TVR), heart failure, and nonfatal stroke. All patients underwent a 12-month follow-up for MACEs after admission. RESULTS Cystatin C was significantly correlated with metabolic risk factors and inflammation markers. The prevalence of MetS and MACEs correlated with cystatin C levels. Cystatin C showed a strong diagnostic performance for cardiovascular risk factors and outcomes in ROC analysis. After adjustment for multiple risk factors, cystatin C level was independently associated with MetS (OR 2.299, 95% CI 1.251-4.225, and P = 0.007). During a 12-month follow-up, the patients with high cystatin C level and MetS had higher incidence of MACEs (Log-rank = 24.586, P < 0.001) and cardiac death (Log-rank = 9.890, P = 0.020) compared to the others. Multivariate Cox analysis indicated that cystatin C level was an independent predictor of MACEs (HR 2.609, 95% CI 1.295-5.257, and P = 0.007). CONCLUSION Cystatin C may be an independent predictor of metabolic syndrome and therefore valuable for management of NSTE-ACS patients. Further multicenter, large-scale studies are required to assess the implication of these results.
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Affiliation(s)
- Qi Mao
- Department of Cardiovascular Medicine, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Ning Zhao
- Department of Cardiovascular Medicine, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Yuqing Wang
- Department of Cardiovascular Medicine, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Youmei Li
- Department of Cardiovascular Medicine, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Chaojun Xiang
- Department of Cardiovascular Medicine, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Lufeng Li
- Department of Cardiovascular Medicine, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Wei Zheng
- Department of Cardiovascular Medicine, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Shangcheng Xu
- Department of Occupational Health, Army Medical University, Chongqing 400038, China
| | - Xiao-Hui Zhao
- Department of Cardiovascular Medicine, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
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Georgakopoulos C, Vlachopoulos C, Lazaros G, Tousoulis D. Biomarkers of Atrial Fibrillation in Metabolic Syndrome. Curr Med Chem 2019; 26:898-908. [PMID: 29022500 DOI: 10.2174/0929867324666171012105528] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 12/27/2016] [Accepted: 12/31/2016] [Indexed: 01/12/2023]
Abstract
Whether the increased atrial fibrillation (AF) risk in metabolic syndrome (MetS) patients is due to the syndrome as a whole or simply the sum of the risks of its individual component parts is still obscure. These two clinical entities share many pathophysiological links and thus distinction between a casual observation and a significant association is difficult. Biomarkers associated with pathogenesis of AF in the context of MetS have the ability to refine future risk prediction. In the present review we identify circulating substances that could be regarded as potential biomarkers for prediction of incident AF, or of cardiovascular events in the setting of AF in patients with MetS. Cardiac myocyte injury and stress markers (troponin and natriuretic peptides), markers of renal function (glomeral filtration rate, cystatin-C), and inflammation markers/mediators (interleukin- 6, CRP) are promising biomarkers of patients with AF and MetS.
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Affiliation(s)
- Christos Georgakopoulos
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian Universty of Athens, Hippokration Hospital, Athens, Greece
| | - Charalambos Vlachopoulos
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian Universty of Athens, Hippokration Hospital, Athens, Greece
| | - Georgios Lazaros
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian Universty of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitrios Tousoulis
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian Universty of Athens, Hippokration Hospital, Athens, Greece
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Relationship of High Circulating Cystatin C to Biochemical Markers of Bone Turnover and Bone Mineral Density in Elderly Males with a Chronic Heart Failure. J Med Biochem 2019; 38:53-62. [PMID: 30820184 PMCID: PMC6298453 DOI: 10.2478/jomb-2018-0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/17/2018] [Indexed: 12/12/2022] Open
Abstract
Background 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). Methods 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). Results 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. Conclusions 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.
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Klisic A, Kavaric N, Soldatovic I, Ninic A, Kotur-Stevuljevic J. Retinol-binding protein 4 better correlates with metabolic syndrome than cystatin C. J LAB MED 2019. [DOI: 10.1515/labmed-2018-0325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Abstract
Background
Retinol-binding protein 4 (RBP4) and cystatin C are regarded as novel metabolic risk markers. Therefore, we aimed to examine which one of these biomarkers better correlates with metabolic syndrome (MetS) in a cohort of postmenopausal women.
Methods
A total of 129 postmenopausal women (among which 62 women had MetS) were recruited in this cross-sectional study. MetS was diagnosed according to the International Diabetes Federation criteria.
Results
Cystatin C and RBP4 levels were significantly higher in women with MetS, compared to those without MetS (p=0.011 vs. p<0.001, respectively). A significant difference in the proportion of women with and without MetS across cystatin C and RBP4 quartiles was observed (χ2=5.1, p=0.025, and χ2=11.1, p=0.001, respectively). Logistic regression analysis revealed a borderline significant relationship between cystatin C and MetS (p=0.066), but this significance disappeared after adjustment for age, inflammation level and duration of menopause (p=0.221). On the contrary, a significant relationship between RBP4 and MetS was observed not only without adjustment (p=0.009), but also even after adjustment for age, inflammation level and duration of menopause (p=0.006).
Conclusions
RBP4 better correlates with MetS than cystatin C in postmenopausal women.
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16
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Schmid C, Ghirlanda C, Zwimpfer C, Tschopp O, Zuellig RA, Niessen M. Cystatin C in adipose tissue and stimulation of its production by growth hormone and triiodothyronine in 3T3-L1 cells. Mol Cell Endocrinol 2019; 482:28-36. [PMID: 30543877 DOI: 10.1016/j.mce.2018.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/11/2018] [Accepted: 12/10/2018] [Indexed: 01/27/2023]
Abstract
Cystatin C (CysC) is a marker for estimation of glomerular filtration rate (GFR). CysC levels may depend not only on clearance/GFR but possibly also on changes in production. Our studies on tissue distribution of CysC protein in mice showed that adipose tissue expresses significant amounts of CysC, suggesting that adipocytes could contribute to circulating CysC levels in vivo. As growth hormone (GH) and triiodothyronine (T3) increase both GFR and CysC (increased in acromegaly and hyperthyroidism) in vivo, we studied whether they could increase CysC production in 3T3-L1 adipocytes in vitro. CysC accumulated in culture media of 3T3-L1 adipocytes in a time-dependent fashion. GH and T3 both (10 nmol/l) increased accumulation of CysC, to 373 ± 14 and 422 ± 20, respectively, vs 298 ± 10 ng per well over 4 days in controls. Thus, GH and T3 enhance the production of CysC by adipocytes in vitro.
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Affiliation(s)
- Christoph Schmid
- Division of Endocrinology, Diabetes & Clinical Nutrition, University Hospital, Zurich, Switzerland.
| | - Claudia Ghirlanda
- Division of Endocrinology, Diabetes & Clinical Nutrition, University Hospital, Zurich, Switzerland
| | - Cornelia Zwimpfer
- Division of Endocrinology, Diabetes & Clinical Nutrition, University Hospital, Zurich, Switzerland
| | - Oliver Tschopp
- Division of Endocrinology, Diabetes & Clinical Nutrition, University Hospital, Zurich, Switzerland
| | - Richard A Zuellig
- Division of Endocrinology, Diabetes & Clinical Nutrition, University Hospital, Zurich, Switzerland
| | - Markus Niessen
- Division of Endocrinology, Diabetes & Clinical Nutrition, University Hospital, Zurich, Switzerland
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Kwon WS, Kim TS, Nahm CH, Moon Y, Kim JJ. Aberrant cystatin-C expression in blood from patients with breast cancer is a suitable marker for monitoring tumor burden. Oncol Lett 2018; 16:5583-5590. [PMID: 30344712 PMCID: PMC6176264 DOI: 10.3892/ol.2018.9380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 03/30/2017] [Indexed: 01/05/2023] Open
Abstract
The present study was performed to evaluate the efficacy of circulating cystatin-C as a tumor monitoring biomarker at different clinical time points in patients with breast cancer over a long-term follow-up period. In addition, the secretory rate of circulating cystatin-C from cancer tissue was investigated by comparing the blood and tissue expression levels of cystatin-C. Blood samples from healthy volunteers (40 males and 40 females) were obtained at yearly health examinations if laboratory and imaging abnormalities were not detected. Blood samples from 34 patients with breast cancer were obtained at 205 different time points of clinical progression. Blood levels of cystatin-C were measured using ELISA and the tissue levels were measured using immunohistochemistry. No age-associated effect was observed in male and female blood cystatin-C levels. The positivity rate was 46% in patients (38/83) and 40% in samples collected at different time points (82/205). Blood cystatin-C levels were lowest following surgery compared with patients with systemic metastasis (P<0.001). The sensitivity, specificity and accuracy rates of ELISA were 53.6, 63.6 and 53.9%, respectively. The concordance rate between blood and tissue expression was 38%. The main reason for discordance between tissue and serum expression of cytostatin-C came from low serum positivity in samples showing tissue cytostatin-C (3/11, 27%). The specificity between cytostatin-C and CA-125 was highest in tumor absence state. In conclusion, elevated blood levels of cystatin-C were observed in 40% of breast cancer cases and were tumor-volume dependent. However, the concordance rate between tissue and blood was quite low, suggesting tumor heterogeneity of cystatin-C expression or co-acting pathway activation, such as cathepsin D. As one-third of breast cancer tissues express cystatin-C without cancer antigen 15-3 elevation, cystatin-C may represent a good tumor-monitoring marker in breast cancer.
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Affiliation(s)
- Woo Sun Kwon
- Song-Dang Institute for Cancer Research, Cancer Metastasis Research Center, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Tae Soo Kim
- Song-Dang Institute for Cancer Research, Cancer Metastasis Research Center, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Chung Hyun Nahm
- Department of Laboratory Medicine, Inha University College of Medicine, Incheon 22332, Republic of Korea
| | - Yeonsook Moon
- Department of Laboratory Medicine, Inha University College of Medicine, Incheon 22332, Republic of Korea
| | - Jin Ju Kim
- Department of Laboratory Medicine, Inha University College of Medicine, Incheon 22332, Republic of Korea
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18
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Dragović G, Srdić D, Al Musalhi K, Soldatović I, Kušić J, Jevtović D, Nair D. Higher Levels of Cystatin C in HIV/AIDS Patients with Metabolic Syndrome. Basic Clin Pharmacol Toxicol 2017; 122:396-401. [PMID: 29024496 DOI: 10.1111/bcpt.12919] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/04/2017] [Indexed: 01/01/2023]
Abstract
Data about Cystatin-C levels in HIV-infected patients with metabolic syndrome (MetS) are still limited. Therefore, the aim of this study was to evaluate the possible correlations of serum levels of Cystatin-C in HIV/AIDS patients treated with combined antiretroviral therapy (cART) with or without MetS. This cross-sectional study included 89 HIV/AIDS Caucasian patients receiving cART at the HIV/AIDS Centre Belgrade, Serbia, divided into two groups according to the presence of MetS. Cystatin-C and other biochemical parameters were measured using Cytokine-Array-I, Metabolic-Array-I and Metabolic-Array-II, at the Department of Clinical Biochemistry, Royal Free Hospital and University College London, UK. A linear regression model was performed to evaluate which clinical and laboratory variables had an independent effect on Cystatin-C levels in HIV/AIDS patients. There were 33 (37%) patients with MetS and 56 (63%) without MetS. Patients with and without MetS were homogenous for age, duration of cART, number of cART combinations and CD4+ T cell count. Statistically increased Cystatin-C levels were observed in HIV/AIDS patients with MetS (p = 0.017), when compared to patients without MetS. Data showed a positive correlation of Cystatin-C and C-reactive protein (r = 0.349, p = 0.001). Using linear regression modelling, significant correlations were obtained between Cystatin-C and MetS in univariate analysis (p < 0.001). Cystatin-C levels were significantly higher in HIV/AIDS patients with MetS versus without MetS. Early assessment of MetS using Cystatin-C as a marker may ultimately help increase the lifespan of HIV/AIDS patients, as these patients appear to be at high risk of cardiovascular diseases.
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Affiliation(s)
- Gordana Dragović
- Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Danica Srdić
- Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Khawla Al Musalhi
- Department of Clinical Biochemistry, Royal Free Hospital and University College London, London, UK
| | - Ivan Soldatović
- Institute for Biomedical Statistics, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Kušić
- Infectious and Tropical Diseases Hospital, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Djordje Jevtović
- Infectious and Tropical Diseases Hospital, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Devaki Nair
- Department of Clinical Biochemistry, Royal Free Hospital and University College London, London, UK
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Zhang J, Shi Z, Huang J, Zou X. CSTB Downregulation Promotes Cell Proliferation and Migration and Suppresses Apoptosis in Gastric Cancer SGC-7901 Cell Line. Oncol Res 2017; 24:487-494. [PMID: 28281969 PMCID: PMC7838608 DOI: 10.3727/096504016x14685034103752] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study aimed to investigate the pivotal role of cystatin B (CSTB) in the development of gastric cancer and to explore its possible regulatory mechanism. Human gastric cancer SGC-7901 cells as a model in vitro were transfected with plasmid PCDNA3.1-CSTB and siRNA-CSTB using Lipofectamine 2000. Quantitative real-time PCR (qRT-PCR) and Western blotting were performed to determine the relative expression of CSTB and PI3K/Akt/mTOR pathway-related protein. Moreover, MTT assay, Transwell assay, and flow cytometry were used to assess cell proliferation, migration, and apoptosis, respectively. The results showed that CSTB was significantly downregulated in SGC-7901 cells compared with gastric epithelial cells. CSTB was successfully overexpressed and suppressed after cells were transfected with pc-CSTB and si-CSTB, respectively. Moreover, cell viability and migration were significantly decreased after being transfected with pc-CSTB when compared with the control group, while being obviously increased after transfection with si-CSTB. However, cell apoptosis was significantly induced after being transfected with pc-CSTB, while being obviously suppressed after transfection with si-CSTB. Besides, the expression levels of p-PI3K, p-Akt, and p-mTOR proteins were all significantly decreased in the pc-CSTB transfection group when compared with the control group, while being increased in the si-CSTB transfection group. Our findings suggest that CSTB downregulation may promote the development of gastric cancer by affecting cell proliferation and migration, and the PI3K/Akt/mTOR signaling pathway was activated in this process. CSTB may serve as a potential therapeutic target for gastric cancer.
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Affiliation(s)
- Jian Zhang
- Department of Cancer Center, The First People's Hospital of Kashi Prefecture, Kashi Prefecture, Xinjiang, P.R. China
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Ying X, Jiang Y, Qin G, Qian Y, Shen X, Jiang Z, Zheng S, Song Z. Association of body mass index, waist circumference, and metabolic syndrome with serum cystatin C in a Chinese population. Medicine (Baltimore) 2017; 96:e6289. [PMID: 28272253 PMCID: PMC5348201 DOI: 10.1097/md.0000000000006289] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The aim of the study was to evaluate the association of body mass index (BMI), waist circumference (WC), and metabolic syndrome (MetS) with serum cystatin C (CysC) in a Chinese population. METHODS The population was composed of 5866 subjects. MetS was diagnosed using the American Heart Association/National Heart, Lung, and Blood Institute 2005 (NCEP-R) criteria. Covariates were analyzed using logistic regression and Spearman partial correlation. RESULTS In this population, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), high sensitivity C-reactive protein (hs-CRP), BMI, WC, systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine (Scr), and CysC were significantly higher, and HDL-C and the estimated glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration) (eGFRCKD-EPI) were significantly lower in the MetS than in the non-MetS group. TG, LDL-C, FPG, hs-CRP, BMI, WC, SBP, DBP, and Scr were significantly higher, and HDL-C and eGFRCKD-EPI were significantly lower in the 4th quartile than in the 1st quartile of CysC. Logistic regression analysis showed that sex, age, hs-CRP, and CysC were independently associated with the presence of MetS (OR = 3.732, 1.028, 1.051, and 3.334, respectively; P < 0.05). No significant association between the presence of MetS and either Scr or eGFRCKD-EPI was observed. After adjustment for age and sex, BMI, WC, hs-CRP, and Scr were all positively correlated, whereas eGFRCKD-EPI was negatively correlated with CysC (r = 0.029, 0.061, 0.189, 0.227, and -0.210, respectively; P < 0.05). CONCLUSION The present study revealed that the CysC was more closely associated with the presence of MetS, as compared Scr or eGFRCKD-EPI. CysC was positively correlated with BMI, and more strongly, positively correlated with WC and inflammation.
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Affiliation(s)
- Xin Ying
- International Health Care Center
| | | | | | | | | | | | - Shu Zheng
- MOE Key Laboratory of Cancer Prevention and Intervention, Cancer Institute, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Kim TJ, Kang MK, Jeong HG, Kim CK, Kim Y, Nam KW, Mo H, An SJ, Ko SB, Yoon BW. Cystatin C is a useful predictor of early neurological deterioration following ischaemic stroke in elderly patients with normal renal function. Eur Stroke J 2016; 2:23-30. [PMID: 31008299 DOI: 10.1177/2396987316677197] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 10/07/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction Cystatin C has been suggested as a sensitive marker of renal function. A high level of cystatin C is related to cardiovascular disease and stroke in elderly patients. We investigated the relationship between levels of cystatin C and early neurological deterioration with acute ischaemic stroke in elderly patients without chronic kidney disease. Patients and methods We evaluated a total of 771 elderly patients (mean age, 72.2; male, 59.0%) without chronic kidney disease who were admitted following acute ischaemic stroke between March 2010 and January 2015. The patients were divided into four groups based on the quartiles of serum cystatin C values. Early neurological deterioration was defined as an increase of ≥2 points from the baseline National Institutes of Health Stroke Scale score during the 7 days following onset. We compared the clinical characteristics and cystatin C concentrations between patients with and without early neurological deterioration. Results Eighty-six patients (11.2%) experienced early neurological deterioration. The percentage values of the higher (third and fourth) quartiles were significantly higher in the early neurological deterioration group (30.2% vs. 24.4% and 34.9% vs. 23.8%, P = 0.002). After adjustment for covariates, higher cystatin C levels were independently associated with a higher risk of early neurological deterioration: odds ratio (95% confidence interval) for second quartile 1.59 (0.70-3.58), third quartile 2.75 (1.25-6.04), fourth quartile 3.12 (1.36-7.16); P for trend 0.026. Discussion and conclusions This study demonstrated that cystatin C concentrations in elderly patients without chronic kidney disease were associated with early neurological deterioration following acute stroke. This suggests that cystatin C level could be a useful predictor for early neurological deterioration following acute stroke.
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Affiliation(s)
- Tae Jung Kim
- Department of Neurology, Seoul National University Hospital, Republic of Korea
| | - Min Kyoung Kang
- Department of Neurology, Seoul National University Hospital, Republic of Korea
| | - Han-Gil Jeong
- Department of Neurology, Seoul National University Hospital, Republic of Korea
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Republic of Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Republic of Korea
| | - Ki-Woong Nam
- Department of Neurology, Seoul National University Hospital, Republic of Korea
| | - Heejung Mo
- Department of Neurology, Seoul National University Hospital, Republic of Korea
| | - Sang Joon An
- Department of Neurology, Seoul National University Hospital, Republic of Korea
| | - Sang-Bae Ko
- Department of Neurology, Seoul National University Hospital, Republic of Korea
| | - Byung-Woo Yoon
- Department of Neurology, Seoul National University Hospital, Republic of Korea
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Mallikethi-Reddy S, Briasoulis A, Akintoye E, Afonso L. Novel biomarkers with potential for cardiovascular risk reclassification. Biomarkers 2016; 22:189-199. [DOI: 10.1080/1354750x.2016.1201540] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Sagar Mallikethi-Reddy
- Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Alexandros Briasoulis
- Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Emmanuel Akintoye
- Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Luis Afonso
- Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
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Yildirim A, Yildizhan B, Anik Ilhan G, Pekin T. Cystatin C, a novel cardiometabolic risk marker in women with polycystic ovary syndrome. Gynecol Endocrinol 2016; 32:457-9. [PMID: 26758793 DOI: 10.3109/09513590.2015.1130807] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the impact of urinary albumin excretion (UAE) and cystatin C on the metabolic components of polycystic ovary syndrome (PCOS). METHODS Seventy-five women with PCOS were divided into two groups according to metabolic syndrome as MetS + and MetS-. Clinical, metabolic and renal parameters were compared between the groups. Correlation analyses were performed between cystatin C, microalbuminuria and clinical and metabolic parameters in women with PCOS. RESULTS Waist/hip ratio (WHR), body mass index, LDL cholesterol, triglyceride, total cholesterol, cystatin C, UAE were significantly higher in the MetS + group compared with the MetS - one. HDL cholesterol was significantly higher in the MetS - group than the MetS + one. The UAE positively correlates with LDL cholesterol, triglyceride and total cholesterol levels. Cystatin C positively correlates with UAE, WHR, LDL cholesterol, triglyceride, total cholesterol levels. CONCLUSIONS Evaluating UAE and cystatin C may be important for the detection of target subjects at high risk for future metabolic syndrome and cardiovascular disease.
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Affiliation(s)
- Aysegul Yildirim
- a Department of Obstetrics and Gynecology , Marmara University , Istanbul , Turkey
| | - Begum Yildizhan
- a Department of Obstetrics and Gynecology , Marmara University , Istanbul , Turkey
| | - Gokce Anik Ilhan
- a Department of Obstetrics and Gynecology , Marmara University , Istanbul , Turkey
| | - Tanju Pekin
- a Department of Obstetrics and Gynecology , Marmara University , Istanbul , Turkey
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Magnusson M, Molvin J, Engström G, Svensson-Färbom P, Persson M, Christensson A, Nilsson P, Melander O. Cystatin C and Risk of Diabetes and the Metabolic Syndrome - Biomarker and Genotype Association Analyses. PLoS One 2016; 11:e0155735. [PMID: 27218257 PMCID: PMC4878806 DOI: 10.1371/journal.pone.0155735] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 05/03/2016] [Indexed: 01/01/2023] Open
Abstract
Background We recently reported a relationship between plasma levels of cystatin C and incidence of the metabolic syndrome (MetS) among the first 2,369 subjects who participated in the re-examination study of the population-based Malmö and Diet Cancer Cardiovascular cohort (MDC-CC-re-exam). In this study we aimed to replicate these results and also investigate if cystatin C was causally associated with MetS and diabetes. Methods We estimated the effect size of the strongest GWAS derived cystatin C SNP (major allele of rs13038305) on plasma cystatin C in the now completed MDC-CC-re-exam (n = 3,734) and thereafter examined the association between plasma cystatin C (403 cases of diabetes and 2665 controls) as well as rs13038305 (235 cases and 2425 controls) with incident diabetes. The association of rs13038305 and incident MetS (511 cases of MetS and 1980 controls) was similarly investigated in the whole MDC-CC-re-exam. We also attempted to replicate our previously shown association of cystatin C with incident MetS in subjects from the MDC-CC-re-exam (147 cases and 711 controls) that were not included in our previous report. Results In the entire MDC-CC-re-exam, each copy of the major allele of rs13038305 was associated with approximately 0.30 standard deviation (SD) higher plasma concentration of cystatin C (β = 0.33, p = 4.2E-28) in age and sex adjusted analysis. Cystatin C in plasma was not associated with incident diabetes after adjustment for known diabetes risk factors (OR per 1 SD increment 0.99 (0.86–1.13), p = 0.842). In the replication cohort of MDC-CC-re-exam, the OR (95% CI) for incident MetS in subjects belonging to quartiles 1, 2, 3 and 4 of plasma cystatin C levels was 1.00 (reference), 1.21 (0.70–2.07), 1.62 (0.95–2.78) and 1.72 (1.01–2.93) (ptrend = 0.026) in age and sex adjusted analysis. In the entire MDC-CC-re-exam the odds ratio for incident MetS and diabetes per copy of the major rs13038305 allele was 1.13, (0.95–1.34), p = 0.160 and 1.07, 95% CI 0.89–1.30, p = 0.478, respectively. Conclusion We were able to replicate our previously shown association between high levels of cystatin C and increased risk of future development of MetS. However, a causal involvement of cystatin C in the etiology of MetS or diabetes seems unlikely since genetic elevation of plasma cystatin C was not significantly related to incidence of these diseases.
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Affiliation(s)
- Martin Magnusson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
- * E-mail:
| | - John Molvin
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Margaretha Persson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Center of Emergency Medicine, Skåne University Hospital, Malmö, Sweden
| | | | - Peter Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Center of Emergency Medicine, Skåne University Hospital, Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Center of Emergency Medicine, Skåne University Hospital, Malmö, Sweden
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Heianza Y, Hara S, Saito K, Tsuji H, Tanaka S, Kodama S, Kobayashi T, Arase Y, Sone H. Assessment of kidney dysfunction with cystatin C- and creatinine-based estimated glomerular filtration rate and predicting type 2 diabetes: Toranomon Hospital Health Management Center Study 21. Diabetes Res Clin Pract 2016; 113:60-8. [PMID: 26972964 DOI: 10.1016/j.diabres.2016.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/17/2016] [Accepted: 01/22/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Whether early stages of kidney dysfunction assessed by the estimated glomerular filtration rate from cystatin C measurements (eGFRCysC) rather than from creatinine measurements (eGFRCr) would more precisely reflect the risk of developing type 2 diabetes (T2D) has not been clarified. We compared the risk of developing T2D associated with renal dysfunction indicated by eGFRCysC or eGFRCr measurements. METHODS Studied were 2131 Japanese individuals without diabetes. Hazard ratios (HRs) for the development of T2D over 3-5 y were calculated across categories of eGFRCysC and eGFRCr, respectively. RESULTS Reduced levels of eGFRCysC were associated with a step-wise increase in the cumulative incidence rate of T2D (p=0.007). In comparison with the eGFRCysC >85th percentile group (≥ 117.4 ml/min/1.73 m(2)), the lowest group, which was the eGFRCysC <15th percentile group (<86.2 ml/min/1.73 m(2)), had an adjusted HR of 2.30 (95% CI 1.13, 4.68) for T2D. Compared with the eGFRCr >85th percentile group, the lowest eGFRCr group (<15th percentile) had an HR of 1.19 (0.63, 2.24) for T2D. However, individuals with eGFRCr <60 ml/min/1.73 m(2) had a significantly increased risk of T2D. Clustering of both low eGFRCysC and low eGFRCr further elevated the HR for T2D compared with the presence of either. CONCLUSIONS Although eGFRCr in ranges indicating chronic kidney disease reflected an elevated risk of developing diabetes, earlier stages of kidney dysfunction indicated by reduced eGFRCysC, which could not be captured by reduced eGFRCr, would be a marker for an elevated risk of developing T2D.
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Affiliation(s)
- Yoriko Heianza
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan
| | - Shigeko Hara
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Kazumi Saito
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan
| | - Hiroshi Tsuji
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Shiro Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Satoru Kodama
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan
| | - Tetsuro Kobayashi
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Yasuji Arase
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan.
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Relationship between cystatin C and metabolic syndrome among Chinese premenopausal and postmenopausal women without recognized chronic kidney disease. Menopause 2016; 22:217-23. [PMID: 25072954 DOI: 10.1097/gme.0000000000000306] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although studies have shown that elevated cystatin C (Cys-C) levels are associated with the risk of metabolic syndrome (MetS) in the general population, few studies have examined the relationship between serum Cys-C levels and MetS, stratified by menopause status, among women in China. Therefore, we conducted this study to assess the relationship between Cys-C levels and MetS in Chinese premenopausal and postmenopausal women. METHODS We performed a cross-sectional analysis of the baseline data of 1,428 Chinese community-dwelling women who participated in the annual health checkup. MetS was defined by the updated National Cholesterol Education Program/Adult Treatment Panel III criteria. Binary logistic regression analysis was performed to estimate the association between Cys-C levels and MetS. One-way analysis of variance, followed by posttest for linear trends, was performed to evaluate the relationships between Cys-C levels and the number of MetS components. Ordinal regression analysis was used to determine whether menopause status and MetS components contribute to elevated levels of Cys-C. RESULTS The mean level of Cys-C was significantly higher in women with MetS than in those without MetS among both premenopausal and postmenopausal women, showing a progressive increase (P for trend < 0.001) in parallel with the progressive increment in the number of MetS components in all women. Higher Cys-C levels were found to be associated with the presence of MetS after adjusting for age, body mass index, and estimated glomerular filtration rate in all women. The higher odds ratio changed little, even after further adjustment for serum blood nitrogen, total cholesterol, low-density lipoprotein cholesterol, drinking status, and smoking status. Elevated Cys-C level was significantly associated with postmenopause status (P = 0.007), increased waist circumference (P = 0.006), and elevated blood pressure (P = 0.025). CONCLUSIONS Higher serum Cys-C levels are positively and independently associated with the presence of MetS in Chinese premenopausal and postmenopausal women. Elevated Cys-C levels are significantly associated with postmenopause status.
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Gonçalves I, Hultman K, Dunér P, Edsfeldt A, Hedblad B, Fredrikson GN, Björkbacka H, Nilsson J, Bengtsson E. High levels of cathepsin D and cystatin B are associated with increased risk of coronary events. Open Heart 2016; 3:e000353. [PMID: 26848396 PMCID: PMC4731836 DOI: 10.1136/openhrt-2015-000353] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/19/2015] [Accepted: 12/23/2015] [Indexed: 12/01/2022] Open
Abstract
Objective The majority of acute coronary syndromes are caused by plaque ruptures. Proteases secreted by macrophages play an important role in plaque ruptures by degrading extracellular matrix proteins in the fibrous cap. Matrix metalloproteinases have been shown to be markers for cardiovascular disease whereas the members of the cathepsin protease family are less studied. Methods Cathepsin D, cathepsin L and cystatin B were measured in plasma at baseline from 384 individuals who developed coronary events (CEs), and from 409 age-matched and sex-matched controls from the Malmö Diet and Cancer cardiovascular cohort. Results Cathepsin D (180 (142–238) vs 163 (128–210), p<0.001), cathepsin L (55 (44–73) vs 52 (43–67), p<0.05) and cystatin B levels (45 (36–57) vs 42 (33–52), p<0.001) were significantly increased in CE cases compared to controls. In addition, increased cathepsin D (220 (165–313) vs 167 (133–211), p<0.001), cathepsin L (61 (46–80) vs 53 (43–68), p<0.05) and cystatin B (46 (38–58) vs 43 (34–54), p<0.05) were associated with prevalent diabetes. Furthermore, cathepsin D and cystatin B were increased in smokers. The HRs for incident CE comparing the highest to the lowest tertile(s) of cathepsin D and cystatin B were 1.34 (95% CI 1.02 to 1.75) and 1.26 (95% CI 1.01 to 1.57), respectively, after adjusting for age, sex, low-density lipoprotein/high-density lipoprotein ratio, triglycerides, body mass index, hypertension and glucose, but these associations did not remain significant after further addition of smoking to the model. In addition, cathepsin D was increased in incident CE cases among smokers after adjusting for cardiovascular risk factors. Conclusions The associations of cathepsin D and cystatin B with future CE provide clinical support for a role of these factors in cardiovascular disease, which for cathepsin D may be of particular importance for smokers.
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Affiliation(s)
- Isabel Gonçalves
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Karin Hultman
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Pontus Dunér
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Andreas Edsfeldt
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Bo Hedblad
- Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Gunilla Nordin Fredrikson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Harry Björkbacka
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Jan Nilsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Eva Bengtsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
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Robberecht H, Hermans N. Biomarkers of Metabolic Syndrome: Biochemical Background and Clinical Significance. Metab Syndr Relat Disord 2016; 14:47-93. [PMID: 26808223 DOI: 10.1089/met.2015.0113] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Biomarkers of the metabolic syndrome are divided into four subgroups. Although dividing them in groups has some limitations, it can be used to draw some conclusions. In a first part, the dyslipidemias and markers of oxidative stress are discussed, while inflammatory markers and cardiometabolic biomarkers are reviewed in a second part. For most of them, the biochemical background and clinical significance are discussed, although here also a well-cut separation cannot always be made. Altered levels cannot always be claimed as the cause, risk, or consequence of the syndrome. Several factors are interrelated to each other and act in a concerted, antagonistic, synergistic, or modulating way. Most important conclusions are summarized at the end of every reviewed subgroup. Genetic biomarkers or influences of various food components on concentration levels are not included in this review article.
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Affiliation(s)
- Harry Robberecht
- Department of Pharmaceutical Sciences, NatuRA (Natural Products and Food Research and Analysis), University of Antwerp , Wilrijk, Antwerp, Belgium
| | - Nina Hermans
- Department of Pharmaceutical Sciences, NatuRA (Natural Products and Food Research and Analysis), University of Antwerp , Wilrijk, Antwerp, Belgium
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Svensson-Färbom P, Almgren P, Hedblad B, Engström G, Persson M, Christensson A, Melander O. Cystatin C Is Not Causally Related to Coronary Artery Disease. PLoS One 2015; 10:e0129269. [PMID: 26057752 PMCID: PMC4461168 DOI: 10.1371/journal.pone.0129269] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 05/06/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Strong and independent associations between plasma concentration of cystatin C and risk of cardiovascular disease (CVD) suggests causal involvement of cystatin C. AIM The aim of our study was to assess whether there is a causal relationship between plasma concentration of cystatin C and risk of coronary artery disease (CAD) using a Mendelian Randomization approach. METHODS We estimated the strength of association of plasma cystatin C on CAD risk and the strength of association of the strongest GWAS derived cystatin C SNP (rs13038305) on plasma cystatin C in the population-based Malmö Diet and Cancer Study (MDC) and thereafter the association between rs13038305 and CAD in the MDC (3200 cases of CAD and 24418 controls) and CARDIOGRAM (22233 cases of CAD and 64762 controls). RESULTS Each standard deviation (SD) increment of plasma cystatin C was associated with increased risk of CAD (OR = 1.20, 95% CI 1.07-1.34) after full adjustment. Each copy of the major allele of rs13038305 was associated with 0.34 SD higher plasma concentration of cystatin C (P<1 x 10-35), resulting in a power of >98% to detect a significant relationship between rs13038305 and CAD in MDC and CARDIOGRAM pooled. The odds ratio for CAD (per copy of the major rs13038305 allele) was 1.00 (0.94-1.07); P = 0.92 in MDC, 0.99 (0.96-1.03); P = 0.84 in CARDIOGRAM and 1.00 (0.97-1.03); P = 0.83 in MDC and CARDIOGRAM pooled. CONCLUSION Genetic elevation of plasma cystatin C is not related to altered risk of CAD, suggesting that there is no causal relationship between plasma cystatin C and CAD. Rather, the association between cystatin C and CAD appears to be due to the association of eGFR and CAD.
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Affiliation(s)
- Patrik Svensson-Färbom
- Trelleborg Hospital, Department of Internal Medicine, Trelleborg, Sweden
- Institution of Clinical Sciences, Lund University, Malmö, Sweden
- * E-mail:
| | - Peter Almgren
- Institution of Clinical Sciences, Lund University, Malmö, Sweden
| | - Bo Hedblad
- Institution of Clinical Sciences, Lund University, Malmö, Sweden
| | - Gunnar Engström
- Institution of Clinical Sciences, Lund University, Malmö, Sweden
| | - Margaretha Persson
- Institution of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Anders Christensson
- Institution of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Nephrology, Skåne University Hospital, Malmö, Sweden
| | - Olle Melander
- Institution of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
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Clinical analysis of the relationship between cystatin C and metabolic syndrome in the elderly. Rev Port Cardiol 2014; 33:411-6. [PMID: 25155006 DOI: 10.1016/j.repc.2014.01.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 12/29/2013] [Accepted: 01/02/2014] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Studies have shown that both cystatin C and metabolic syndrome (MetS) are associated with inflammation. We set out to investigate the correlation between serum cystatin C levels and MetS in the elderly. METHODS This prospective study was conducted in 380 elderly individuals, including 135 patients with MetS, 142 patients with metabolic disturbance (MetD), and 103 healthy elderly individuals (control group). Waist-hip ratio, waist circumference, waist-height ratio, body mass index (BMI), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure and cystatin C were measured and their mutual relations were analyzed. RESULTS The higher the MetS scores, the higher the serum cystatin C concentration in these patients. Serum cystatin C concentration was closely related to waist-hip ratio, waist circumference, waist-height ratio, BMI, TG, FPG, and blood pressure, not related to LDL-C levels, and negatively correlated with HDL-C levels. Logistic regression analysis indicated that cystatin C, waist-height ratio, waist circumference, FPG, TG, SBP and pulse pressure were significantly associated with MetS (OR between cystatin C and MetS 2.164, 95% CI 1.136-8.259). CONCLUSION Cystatin C was significantly associated with MetS in the elderly. As MetS scores rose, serum cystatin C levels increased.
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Panaich SS, Veeranna V, Bavishi C, Zalawadiya SK, Kottam A, Afonso L. Association of cystatin C with measures of obesity and its impact on cardiovascular events among healthy US adults. Metab Syndr Relat Disord 2014; 12:472-6. [PMID: 25118891 DOI: 10.1089/met.2014.0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND This study sought to explore the relationship between cystatin C (CysC) and anthropometric measures of obesity and the influence of this association on mortality [cardiovascular disease (CVD), coronary heart disease, and all-cause] in a nationally representative population free of CVD, diabetes mellitus, and macroalbuminuria (MA). METHODS The study cohort included 4577 adult participants of the Third National Health and Nutrition Examination Survey (NHANES). Spearman correlation analysis was performed to ascertain the association between various anthropometric measures and CysC. Formal statistical analyses of the interaction term between anthropometric measures and CysC for outcomes were performed followed by stratified multivariate Cox proportional hazard analyses. RESULTS A moderate degree of association was seen between CysC and measures of visceral adiposity as represented by waist-to-height ratio (WHR) and waist circumference (WC) and only a weak association between CysC and body mass index (BMI). CysC was predictive of all study outcomes in individuals with normal anthropometric measurements only. CONCLUSIONS CysC correlated better with measures of visceral adiposity (WC and WHR) compared to BMI and appears to be a better predictor of adverse cardiovascular outcomes among those with anthropometric measures not suggestive of obesity compared to those with abnormal measures of anthropometry.
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Affiliation(s)
- Sidakpal S Panaich
- 1 Department of Cardiology, Wayne State University/Detroit Medical Center , Detroit, Michigan
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Cystatin C: An underexplored biomarker that goes beyond renal function. Rev Port Cardiol 2014; 33:417-8. [DOI: 10.1016/j.repc.2014.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 07/10/2014] [Indexed: 11/21/2022] Open
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Liu P, Sui S, Xu D, Xing X, Liu C. Clinical analysis of the relationship between cystatin C and metabolic syndrome in the elderly. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.repce.2014.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Andrade MJ. Cystatin C: An underexplored biomarker that goes beyond renal function. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.repce.2014.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Cystatin C as a predictor of mortality and cardiovascular events in a population with chronic kidney disease. Int J Nephrol 2014; 2014:127943. [PMID: 24672725 PMCID: PMC3942201 DOI: 10.1155/2014/127943] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 12/14/2013] [Accepted: 12/17/2013] [Indexed: 01/07/2023] Open
Abstract
Background. We examine whether cystatin C, a surrogate marker of renal function, could identify patients with chronic kidney disease (CKD) with an increased risk of renal disease progression, death, or cardiovascular events. Methods. Data were obtained for 180 patients, with a diagnosis of chronic renal failure based on serum creatinine estimated glomerular filtration rate (eGFRcreat) <90 mL/min/1.73 m(2). This population was grouped in tertiles according to cystatin C and creatinine values at baseline. Cardiovascular events and overall mortality were estimated for each tertile. Predictors of overall mortality and for the development of renal disease progression were analyzed. Results. The median age was 75 years (interquartile range 69-82) and the median eGFRcreat 38 mL/min m(2) (interquartile range 33-49). Overall mortality was lower on the first and on the second tertiles of cystatin C than on the third one (HR = 0.060; 95% CI: 0.008-0.447 and HR = 0.094; 95% CI: 0.022-0.406, resp.). Deaths related to the creatinine tertiles followed the same pattern, but differences were not as large. Cardiovascular mortality was lower on the second than on the third cystatin C tertile (HR = 0.198; 95% CI: 0.040-0.987), but it did not show differences on the first and the second creatinine tertiles compared with the third one (HR = 0.126; 95% CI: 0.013-1.265 and HR = 0.403; 95% CI: 0.093-1.740). The only independent predictors of mortality during followup were baseline cystatin C (OR = 0.100; 95% CI: 0.021-0.463) and baseline uric acid (OR = 1.377; 95% CI: 1.070-1.773). Conclusion. Cystatin C may be an alternative to creatinine for detecting a high risk of death and cardiovascular events in a population with CKD.
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Kranendonk MEG, de Kleijn DPV, Kalkhoven E, Kanhai DA, Uiterwaal CSPM, van der Graaf Y, Pasterkamp G, Visseren FLJ. Extracellular vesicle markers in relation to obesity and metabolic complications in patients with manifest cardiovascular disease. Cardiovasc Diabetol 2014; 13:37. [PMID: 24498934 PMCID: PMC3918107 DOI: 10.1186/1475-2840-13-37] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 01/18/2014] [Indexed: 12/12/2022] Open
Abstract
Background Alterations in extracellular vesicles (EVs), including exosomes and microparticles, contribute to cardiovascular disease. We hypothesized that obesity could favour enhanced release of EVs from adipose tissue, and thereby contribute to cardiovascular risk via obesity-induced metabolic complications. The objectives of this study were: 1) to investigate the relation between the quantity, distribution and (dys) function of adipose tissue and plasma concentrations of atherothrombotic EV-markers; 2) to determine the relation between these EV-markers and the prevalence of the metabolic syndrome; and 3) to assess the contribution of EV markers to the risk of incident type 2 diabetes. Methods In 1012 patients with clinically manifest vascular disease, subcutaneous and visceral fat thickness was measured ultrasonographically. Plasma EVs were isolated and levels of cystatin C, serpin G1, serpin F2 and CD14 were measured, as well as fasting metabolic parameters, hsCRP and adiponectin. The association between adiposity, EV-markers, and metabolic syndrome was tested by multivariable linear and logistic regression analyses. As sex influences body fat distribution, sex-stratified analyses between adipose tissue distribution and EV-markers were performed. The relation between EV-markers and type 2 diabetes was assessed with Cox regression analyses. Results Higher levels of hsCRP (β 5.59; 95% CI 3.00–8.18) and lower HDL-cholesterol levels (β-11.26; 95% CI −18.39 – -4.13) were related to increased EV-cystatin C levels, and EV-cystatin C levels were associated with a 57% higher odds of having the metabolic syndrome (OR 1.57; 95% CI 1.19–2.27). HDL-cholesterol levels were positively related to EV-CD14 levels (β 5.04; 95% CI 0.07–10.0), and EV-CD14 levels were associated with a relative risk reduction of 16% for development of type 2 diabetes (HR 0.84, 95% CI 0.75–0.94), during a median follow up of 6.5 years in which 42 patients developed type 2 diabetes. Conclusions In patients with clinically manifest vascular disease, EV-cystatin C levels were positively related, and EV-CD14 levels were negatively related to metabolic complications of obesity.
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Affiliation(s)
| | | | | | | | | | | | | | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Centre Utrecht (UMCU), F02,126, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands.
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Magnusson M, Hedblad B, Engström G, Persson M, Nilsson P, Melander O. Response to letter to the editor 'Serum cystatin-C levels correlate with endothelial dysfunction in patients with the metabolic syndrome'. J Intern Med 2013; 274:496-8. [PMID: 23841579 DOI: 10.1111/joim.12110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2013] [Indexed: 11/26/2022]
Affiliation(s)
- M Magnusson
- Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden; Department of Heart Failure and Valvular Disease, Skåne University Hospital, Malmö, Sweden
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Balta S, Demirkol S, Ay SA, Cakar M, Sarlak H, Celik T. Serum cystatin-C levels correlate with endothelial dysfunction in patients with the metabolic syndrome. J Intern Med 2013; 274:200-1. [PMID: 23600475 DOI: 10.1111/joim.12078] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Balta
- Department of Cardiology; Gulhane Medical Academy; Ankara Turkey
| | - S. Demirkol
- Department of Cardiology; Gulhane Medical Academy; Ankara Turkey
| | - S. A. Ay
- Department of Internal Medicine; Gulhane Medical Academy; Ankara Turkey
| | - M. Cakar
- Department of Internal Medicine; Gulhane Medical Academy; Ankara Turkey
| | - H. Sarlak
- Department of Internal Medicine; Gulhane Medical Academy; Ankara Turkey
| | - T. Celik
- Department of Cardiology; Gulhane Medical Academy; Ankara Turkey
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