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Cystatin-C and inflammatory markers in the ambulatory elderly.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | Cystatin-C and inflammatory markers in the ambulatory elderly. |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Shlipak, MG, Katz, R, Cushman, M, Sarnak, MJ, Stehman-Breen, C, Psaty, BM, Siscovick, D, Tracy, RP, Newman, A, Fried, L |
| Journal | Am J Med |
| Volume | 118 |
| Issue | 12 |
| Pagination | 1416 |
| Date Published | 2005 Dec |
| ISSN | 1555-7162 |
| Keywords | Age Factors, Aged, Biomarkers, C-Reactive Protein, Cross-Sectional Studies, Cystatin C, Cystatins, Female, Fibrinogen, Glomerular Filtration Rate, Humans, Kidney Diseases, Male, Predictive Value of Tests, Sensitivity and Specificity |
| Abstract | <p><b>PURPOSE: </b>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.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p> |
| DOI | 10.1016/j.amjmed.2005.07.060 |
| Alternate Journal | Am J Med |
| PubMed ID | 16378798 |
| Grant List | N01 HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States R01 HL073208-01 / HL / NHLBI NIH HHS / United States |