Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2010;63:415-22 - Vol. 63 Num.04 DOI: 10.1016/S1885-5857(10)70090-6

Cystatin C and Cardiovascular Risk in the General Population

Javier Cepeda a, Salvador Tranche-Iparraguirre b, Rafael Marín-Iranzo c, Eloy Fernández-Rodríguez d, Alba Riesgo-García c, Juan García-Casas e, Eduardo Hevia-Rodríguez f

a Servicio de Análisis Clínicos, Hospital Santos Reyes, Sanidad de Castilla y León (SACYL), Aranda de Duero, Burgos, Spain
b Centro de Salud El Cristo, Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Asturias, Spain
c Unidad de Hipertensión, Hospital Universitario Central de Asturias, SESPA, Oviedo, Asturias, Spain
d Servicio de Análisis Clínicos, Hospital de Cabueñes, SESPA, Gijón, Asturias, Spain
e Departamento de Medicina Preventiva y Salud Pública, Universidad de Oviedo, Asturias, Spain
f Centro de Salud Cabañaquinta, SESPA, Mieres, Asturias, Spain

Keywords

Cystatin C. Estimated glomerular filtration rate. Chronic kidney disease. Cardiovascular risk. Cardiovascular disease.

Abstract

Introduction and objectives. Cystatin C has been proposed as a novel marker of renal function and as a predictor of cardiovascular risk in the elderly. The aim of this study was to determine the prevalence of an elevated cystatin C level in the general population and its relationship with cardiovascular risk factors and disease. Methods. This descriptive epidemiologic cross-sectional study involved a simple randomized sample of individuals aged >49 years from the general population, and was based on personal health records. From the final selection of 415 individuals, 359 underwent cystatin C measurement using a immunonephelometric assay. The cut-point used was that recommended for the method in adults. Results. Of the 359 individuals (mean±standard deviation age, 64±10 years, 63.5% female) studied, 17.3% (95% confidence interval [CI] 13.4%-21.2%) had an elevated cystatin C level. The mean level was 0.81±0.21 mg/L, and increased with age. Elevation of the cystatin C level was associated with: older age (P < .0001); high measures of systolic blood pressure (P < .0001), hemoglobin A1c (P=.031), triglycerides (P=.019), homocysteine (P < .0001), C-reactive protein (P=.015), fibrinogen (P=.006) and microalbuminuria (P=.001); and a low high-density lipoprotein cholesterol level (P=.021) and estimated glomerular filtration rate (P < .0001). Associated cardiovascular diseases included coronary heart disease (P=.013) and heart failure (P=.038). The main factors independently associated with an elevated cystatin C level were diabetes (odds ratio [OR]=5.37), male sex (OR=4.91) and decreased glomerular filtration (OR=0.83). Conclusions. The prevalence of an elevated cystatin C level in the general population was found to be high and was associated with the presence of classical cardiovascular risk factors such as diabetes, hypertension and chronic renal disease, along with higher levels of C-reactive protein, homocysteine and fibrinogen.

1885-5857/© 2010 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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