Previous studies indicated that serum cystatin C, a marker of renal function, was
associated with cardiovascular disease (CVD). However, few data about this association
are available for persons without chronic kidney disease or albuminuria. Data from
4,991 subjects in the Third National Health and Nutrition Examination Survey with
an estimated glomerular filtration rate ≥60 ml/min/1.73 m2 without micro- or macroalbuminuria were analyzed. Subjects were categorized into
quartiles of serum cystatin C and compared for prevalence of CVD. CVD was defined
as a history of myocardial infarction, angina, or stroke. After age standardization,
prevalences of CVD from the lowest to highest quartile of serum cystatin C were 6.0%,
8.8%, 11.8%, and 16.7% (p-trend = 0.006). Also, age-standardized prevalences of myocardial
infarction across quartiles of serum cystatin C were 1.9%, 4.4%, 6.6%, and 8.6%; age-standardized
prevalences of angina were 2.4%, 4.4%, 4.2%, and 7.1%; and age-standardized prevalences
of stroke were 2.5%, 1.6%, 3.5%, and 4.4% (each p-trend <0.05). Each 1-SD higher serum
cystatin C level was associated with a multivariate prevalence ratio of CVD of 1.55
(95% confidence interval [CI] 1.13 to 2.13), and multivariate-adjusted prevalence
ratios were 1.44 (95% CI 1.01 to 2.07), 1.64 (95% CI 1.02 to 2.64), and 1.65 (95%
CI 1.06 to 2.56) for myocardial infarction, angina, and stroke, respectively. In conclusion,
a graded association exists between higher serum cystatin C and increased CVD prevalence
in patients without established chronic kidney disease.
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Article info
Publication history
Published online: May 06, 2008
Accepted:
February 18,
2008
Received in revised form:
February 18,
2008
Received:
November 27,
2007
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
