The Impact of Demographic Characteristics and Lifestyle in the Distribution of Cystatin C Values in a Healthy Greek Adult Population

Evangelopoulos, Angelos; Bountziouka, Vassiliki; Giotopoulou, A.; Bonou, Μaria; Barbetseas, John; Avgerinos, Peter C.; Panagiotakos, Demosthenes B.

doi:10.4061/2011/163281

Cited by 7 publications

(7 citation statements)

References 30 publications

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“…However, our study design does not allow us to draw conclusions about what constitutes these unique environmental factors. Previously reported environmental factors that are associated with cystatin C or mild eGFR reduction are smoking, occupational exposure to lead and arsenic, use of corticosteroids, and thyroid dysfunction . When we adjusted for the traditional risk factors serum cholesterol, diabetes mellitus, antihypertensive treatment, systolic blood pressure, smoking, and decreased kidney function, the association between cystatin C and stroke remained.…”

Section: Discussionmentioning

confidence: 81%

“…Previously reported environmental factors that are associated with cystatin C or mild eGFR reduction are smoking, occupational exposure to lead and arsenic, use of corticosteroids, and thyroid dysfunction. [30][31][32][33][34][35] When we adjusted for the traditional risk factors serum cholesterol, diabetes mellitus, antihypertensive treatment, systolic blood pressure, smoking, and decreased kidney function, the association between cystatin C and stroke remained. This indicates that other external factors are important for the strong association between cystatin C and incident ASCVD and may also be possible to prevent if identified.…”

Section: Discussionmentioning

confidence: 99%

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Cystatin C Predicts Incident Cardiovascular Disease in Twins

Arpegård

Magnusson

Chen

et al. 2016

JAHA

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BackgroundCystatin C is associated with both renal function and atherosclerotic cardiovascular disease (ASCVD). We have previously shown a genetic correlation between cystatin C and prevalent ASCVD. The objective of this article is to study whether variation in cystatin C or creatinine predicts incident ASCVD when controlled for genetic factors.Methods and ResultsThe predictive value of cystatin C and creatinine for incident ASCVD was studied in 11 402 Swedish twins, free of CVD at baseline, in an adjusted Cox‐regression model during a median follow‐up of 71 months. Twin pairs discordant for incident stroke, myocardial infarction and ASCVD during follow‐up were identified and within‐pair comparisons regarding cystatin C and creatinine levels were performed. We also investigated whether contact frequency and degree of shared environment influences were associated with similarity in cystatin C levels. In univariate analysis, cystatin C predicted incident ASCVD hazard ratio 1.57, 95% CI 1.47–1.67. When adjusted for traditional Framingham risk factors as covariates, cystatin C remained a predictor of incident stroke hazard ratio 1.45, 95% CI (1.25–1.70), ASCVD hazard ratio 1.26, 95% CI (1.13–1.41), and myocardial infarction hazard ratio 1.16, 95% CI (1.01–1.33). In twins discordant for incident stroke, cystatin C at baseline was higher in the twin who experienced a stroke compared to the healthy co‐twin (1.11±0.3 mg/L versus 1.06±0.3 mg/L), whereas creatinine was lower in the twin who developed CVD compared to their healthy co‐twins (76.1±16.9 μmol/L versus 79.4±20.3 μmol/L).ConclusionsVariation in cystatin C relates to incident ASCVD and to stroke when adjusted for genetic confounding. In identical twins, cystatin C may be a sensitive marker of early hypertensive end‐organ damage and small‐vessel disease, whereas creatinine level may reflect nutritional status. The findings in disease‐discordant monozygotic twins indicate that unique, possibly preventable, environmental factors are important.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Cystatin C Predicts Incident Cardiovascular Disease in Twins

Arpegård

Magnusson

Chen

et al. 2016

JAHA

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“…Literature on sex difference of SCysC is polarized, with most investigators not finding any significant sex difference. 14, 15 Evangelopoulos and associates 16 studied 490 healthy adults and observed higher levels of SCysC in men as compared to women across all age groups. Groesbeck and associates 17 observed 12.7% higher values of SCysC in males than those for females among 719 US adolescents between 12 and 19 years of age.…”

Section: Discussionmentioning

confidence: 98%

Cystatin C as a Marker of Glomerular Filtration Rate in Voluntary Kidney Donors

Jaisuresh

Sharma²,

Mehrothra³

et al. 2012

Exp Clin Transplant

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Objectives: Cystatin C is emerging as an endogenous marker of glomerular filtration rate. This study sought to assess the usefulness of serum cystatin C as a marker of glomerular filtration rate in comparison with serum creatinine and serum creatinine-based glomerular filtration rate estimations in voluntary kidney donors. 99m Tc-DTPA double plasma sampling method. Glomerular filtration rate-double plasma sampling method was used as a reference value. Results were expressed as means ± SD. Results: The mean age of the participants was 44.23 ± 8.61 years old (19 women, 16 men). The mean serum creatinine was 0.83 ± 0.14 mg/dL, and the mean serum cystatin C was 0.71 ± 0.12 mg/L. Serum cystatin C showed significant correlation with serum creatinine (r = 0.864; P < .001). Glomerular filtration rate-MDRD showed the strongest correlation with glomerular filtration ratedouble plasma sampling method (r = 0.93; P < .001), followed by glomerular filtration rate-CockcroftGault (r = 0.76; P < .001 ), serum creatinine (r = -0.68; P < .001), and serum cystatin C (r = -0.59; P < .001). The mean serum cystatin C values were 22.6% higher in men than in women. There was a significant correlation of serum cystatin C with glomerular filtration rate-Cockcroft-Gault (r = -0.50; P = .002 ), glomerular filtration rate-MDRD (r = -0.59; P < .001 ), and glomerular filtration rate-double plasma sampling method (r = -0.59; P < .001 ). Conclusions: Serum cystatin C is an optimal marker of glomerular filtration rate in voluntary kidney donors.

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“…For sample size planning, no stratification and approximately normally distributed data for log-transformed cystatin C values and calculated log-transformed GFR values are assumed. The location parameter and standard deviation of cystatin C at baseline are assumed to be 0.9 mg/L and 0.2 mg/L, respectively, based on the publication by Evangelopoulos and colleagues [ 23 ]. Thereby we consider the older patient groups and greater variability because subgroups are pooled and study patients did not represent a healthy population.…”

Section: Methodsmentioning

confidence: 99%

Comparison of 6 % hydroxyethyl starch and 5 % albumin for volume replacement therapy in patients undergoing cystectomy (CHART): study protocol for a randomized controlled trial

Kämmerer

Klug

Schwarz

et al. 2015

Trials

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BackgroundThe use of artificial colloids is currently controversial, especially in Central Europe Several studies demonstrated a worse outcome in intensive care unit patients with the use of hydroxyethyl starch. This recently even led to a drug warning about use of hydroxyethyl starch products in patients admitted to the intensive care unit. The data on hydroxyethyl starch in non–critically ill patients are insufficient to support perioperative use.Methods/DesignWe are conducting a single-center, open-label, randomized, comparative trial with two parallel patient groups to compare human albumin 5 % (test drug) with hydroxyethyl starch 6 % 130/0.4 (comparator). The primary endpoint is cystatin C ratio, calculated as the ratio of the cystatin value at day 90 after surgery relative to the preoperative value. Secondary objectives are inter alia the evaluation of the influence of human albumin and hydroxyethyl starch on further laboratory chemical and clinical parameters, glycocalyx shedding, intensive care unit and hospital stay and acute kidney injury as defined by RIFLE criteria (risk of renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage kidney disease) criteria.DiscussionThere is a general lack of evidence on the relative safety and effects of hydroxyethyl starch compared with human albumin for volume replacement in a perioperative setting. Previously conducted studies of surgical patients in which researchers have compared different hydroxyethyl starch products included too few patients to properly evaluate clinical important outcomes such as renal function. In the present study in a high-risk patient population undergoing a major surgical intervention, we will determine if perioperative fluid replacement with human albumin 5 % will have a long-term advantage over a third-generation hydroxyethyl starch 130/0.4 on the progression of renal dysfunction until 90 days after surgery.Trial registrationEudraCT number 2010-018343-34. Registered on 11 January 2010.

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The Impact of Demographic Characteristics and Lifestyle in the Distribution of Cystatin C Values in a Healthy Greek Adult Population

Cited by 7 publications

References 30 publications

Cystatin C Predicts Incident Cardiovascular Disease in Twins

Cystatin C Predicts Incident Cardiovascular Disease in Twins

Cystatin C as a Marker of Glomerular Filtration Rate in Voluntary Kidney Donors

Comparison of 6 % hydroxyethyl starch and 5 % albumin for volume replacement therapy in patients undergoing cystectomy (CHART): study protocol for a randomized controlled trial

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