02928nas a2200433 4500008004100000022001400041245006700055210006500122260001300187300000900200490000800209520175900217653001601976653000901992653001502001653002302016653002802039653001502067653001402082653001102096653001502107653003102122653001102153653002002164653000902184653003002193653003202223100002402255700001602279700001802295700002002313700002902333700002002362700002102382700002202403700001702425700001702442856003502459 2005 eng d a1555-716200aCystatin-C and inflammatory markers in the ambulatory elderly.0 aCystatinC and inflammatory markers in the ambulatory elderly c2005 Dec a14160 v1183 a
PURPOSE: Inflammatory factors are elevated in persons with severe renal dysfunction, but their association across all levels of renal function is unclear. We compared cystatin-C, a novel marker of renal function, with creatinine and estimated glomerular filtration rate (eGFR) as predictors of C-reactive protein and fibrinogen levels.
METHODS: This study is a cross-sectional analysis to evaluate cystatin-C, creatinine, and eGFR as predictors of the inflammatory markers C-reactive protein and fibrinogen. Participants included 4637 ambulatory elderly patients from the Cardiovascular Health Study. Multivariate linear regression was used to determine the independent associations of each renal function measurement with the inflammatory marker outcomes.
RESULTS: After adjustment for confounding factors, cystatin-C was correlated with both C-reactive protein (coefficient = 0.13; 95% confidence interval: 0.10-1.16, P <.0001) and fibrinogen levels (0.15; 0.13-0.18, P <.0001). Associations were larger than those for creatinine and C-reactive protein (0.05; 0.02-0.07, P = .003) or fibrinogen (0.07; 0.04-0.10, P <.0001). Adjusted levels of C-reactive protein increased incrementally across quintiles of cystatin-C, from a median of 2.2 mg/L in quintile 1 to 3.7 mg/L in quintile 5. In contrast, both C-reactive protein and fibrinogen had U-shaped associations with quintiles of creatinine and eGFR, because the inflammatory markers were equivalently elevated in quintiles 1 and 5.
CONCLUSIONS: The finding of a significant linear association of cystatin-C and inflammation markers suggests that even small reductions in renal function may be associated with adverse pathophysiologic consequences.
10aAge Factors10aAged10aBiomarkers10aC-Reactive Protein10aCross-Sectional Studies10aCystatin C10aCystatins10aFemale10aFibrinogen10aGlomerular Filtration Rate10aHumans10aKidney Diseases10aMale10aPredictive Value of Tests10aSensitivity and Specificity1 aShlipak, Michael, G1 aKatz, Ronit1 aCushman, Mary1 aSarnak, Mark, J1 aStehman-Breen, Catherine1 aPsaty, Bruce, M1 aSiscovick, David1 aTracy, Russell, P1 aNewman, Anne1 aFried, Linda uhttps://chs-nhlbi.org/node/876