Cystatin C Associates with Arterial Stiffness in Older Adults

Madero, Magdalena; Wassel, Christina L.; Peralta, Carmen A.; Najjar, Samer S.; Sutton-Tyrrell, Kim; Fried, Linda F.; Canada, Robert B.; Newman, Anne B.; Shlipak, Michael G.; Sarnak, Mark J.

doi:10.1681/asn.2008030318

Cited by 53 publications

(37 citation statements)

References 35 publications

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“…Evidence has suggested that S-CysC is associated with GFR reduction and arterial stiffness in patients with conventional CVD risk factors (15,16,32,33). We also found that S-CysC is significantly correlated with the prognostic stages of CKD.…”

Section: Discussionsupporting

confidence: 73%

Urinary Cystatin C as a Potential Risk Marker for Cardiovascular Disease and Chronic Kidney Disease in Patients with Obesity and Metabolic Syndrome

Satoh‐Asahara¹,

Suganami²,

Majima³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and Objectives Obesity and metabolic syndrome (MS) increase the risk of cardiovascular disease (CVD), chronic kidney disease (CKD), and all-cause mortality. Serum cystatin C (S-CysC), a marker of GFR, has been shown to be associated with CVD and CKD. This study was designed to elucidate the association of urinary CysC (U-CysC), a marker of renal tubular dysfunction, with CVD and CKD risk factors in patients with obesity and MS. Design, setting, participants, & measurementsThe U-CysC-creatinine ratio (UCCR) was examined in 343 Japanese obese outpatients enrolled in the multi-centered Japan Obesity and Metabolic Syndrome Study.Results UCCR was positively correlated with urine albumin-creatinine ratio (UACR) and S-CysC and negatively correlated with estimated GFR (eGFR). Among obese patients, UCCR was significantly higher in MS patients than in non-MS patients. UCCR had significant correlations with the number of components of MS and arterial stiffness, all of which are CVD predictors, similarly to UACR (P Ͻ 0.05). Interestingly, diet-and exercise-induced weight reduction for 3 months significantly decreased only UCCR among all of the renal markers examined (P Ͻ 0.01), in parallel with the decrease in BMI, HbA1c, and arterial stiffness, suggesting the beneficial effect of weight reduction on renal tubular dysfunction. ConclusionsThis study demonstrates that UCCR is significantly associated with renal dysfunction, the severity of MS, arterial stiffness, and weight change in obese patients. The data of this study suggest that UCysC could serve as a CVD and CKD risk factor in patients with obesity and MS.

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Section: Discussionsupporting

confidence: 73%

Urinary Cystatin C as a Potential Risk Marker for Cardiovascular Disease and Chronic Kidney Disease in Patients with Obesity and Metabolic Syndrome

Satoh‐Asahara¹,

Suganami²,

Majima³

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…There are fewer data on the relationship of vascular stiffness to longitudinal kidney function de-cline. An analysis of well functioning older adults from the Health, Aging and Body Composition (Health ABC) study, we noted that higher levels of cystatin C, a marker of impaired kidney function, but not creatinine, were associated with higher pulse wave velocity (aPWV) (4). This study was cross-sectional, so the direction of association is unclear.…”

Section: Introductionmentioning

confidence: 82%

Association of Arterial Rigidity with Incident Kidney Disease and Kidney Function Decline

Madero¹,

Peralta²,

Katz³

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objective The association of large arterial rigidity and kidney function decline in longitudinal analyses is not well established. This study evaluated the association of aortic pulse wave velocity (aPWV) and pulse pressure (PP) with rapid kidney function decline and incident CKD in the Health, Aging and Body Composition study.Design, setting, participants, & measurements Participants were 2129 older adults with a baseline measurement of aPWV, PP, and cystatin C and at least one additional measurement of cystatin C, either at year 3 or year 10. Outcomes were rapid kidney function decline (estimated GFR cysC loss of .3 ml/min per 1.73 m 2 per year) and incident CKD (eGFR cysC , 60 ml/min per 1.73 m 2 in participants with baseline estimated GFR . 60 ml/min per 1.73 m 2 ). Multivariate regression models were used to evaluate association of aPWV and PP with each outcome.Results Mean (SD) baseline estimated GFR cysC was 79629 ml/min per 1.73 m 2 . Median follow-up duration was 8.9 years. In multivariable analyses, aPWV was not associated with rapid decline (odds ratio [OR], 95% confidence interval [CI] 1.16, 0.89-1.52) but was associated with incident CKD (incident rate ratio [IRR], 95% CI, 1.39, 1.09-1.77) and PP was associated with both rapid decline (OR, 95% CI 1.10, 1.04-1.16) and incident CKD (IRR, 95% CI, 1.06, 1.01-1.11).Conclusions Large arterial stiffness assessed by aPWV and pulsatility assessed by PP were associated with incident CKD among older adults. Pulsatility assessed by PP was associated with rapid kidney function decline and incident CKD. Future research should determine whether interventions targeting arterial rigidity will prevent CKD development and progression.

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“…[122][123][124][125] Recent studies have suggested that serum cystatin C can reflect artery stiffness. 126,127 Interestingly, data from a population-based study showed that high serum cystatin C levels were associated with increased left ventricular mass, concentric ventricular hypertrophy, and function. 128 However, only recently has research been conducted to evaluate whether circulating cathepsin levels can be used as a predictive biomarker for patients with CCVD.…”

Section: Circulating Cathepsins and Cystatin C As Biomarkers For Ccvdmentioning

confidence: 99%

Role for Cysteine Protease Cathepsins in Heart Disease

et al. 2012

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Cystatin C Associates with Arterial Stiffness in Older Adults

Cited by 53 publications

References 35 publications

Urinary Cystatin C as a Potential Risk Marker for Cardiovascular Disease and Chronic Kidney Disease in Patients with Obesity and Metabolic Syndrome

Urinary Cystatin C as a Potential Risk Marker for Cardiovascular Disease and Chronic Kidney Disease in Patients with Obesity and Metabolic Syndrome

Association of Arterial Rigidity with Incident Kidney Disease and Kidney Function Decline

Role for Cysteine Protease Cathepsins in Heart Disease

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