High levels of cystatin C predict the metabolic syndrome: the prospective Malmö Diet and Cancer Study. (4th March 2013)

• Record Type: Journal Article
• Authors: Magnusson, M.; Hedblad, B.; Engström, G.; Persson, M.; Nilsson, P.; Melander, O.
• Is Part Of: Journal of internal medicine. Volume 274:Number 2(2013:Aug.)
• Page Start: 192
• Page End: 199
• Publication Date: 2013-03-04
• Subjects: Internal medicine -- Periodicals; Medicine -- Periodicals; 616
• DOI: 10.1111/joim.12051
• Languages: English
• ISSNs: 0954-6820

Abstract

<abstract abstract-type="main" id="joim12051-abs-0001"> <title>Abstract</title> <sec id="joim12051-sec-0001" sec-type="section"> <title>Objective</title> <p>Cystatin C is a novel marker of cardiovascular disease (CVD); however, the underlying mechanisms remain unclear. Here, we prospectively investigated whether plasma levels of cystatin C predict new‐onset metabolic syndrome (MetS) as well as long‐term progression and incidence of the different components of the MetS.</p> </sec> <sec id="joim12051-sec-0002" sec-type="section"> <title>Methods</title> <p>Cystatin C was measured in 1502 individuals included in the Malmö Diet and Cancer cardiovascular cohort (mean age 56 years, 59% women) who were free from the MetS at baseline and subsequently underwent a follow‐up examination after a median of 16 years. MetS was defined according to the NCEP‐ATP‐III guidelines. Logistic regression was used to adjust for covariates.</p> </sec> <sec id="joim12051-sec-0003" sec-type="section"> <title>Main outcome measures</title> <p>Metabolic syndrome and long‐term progression as well as incidence of the different components of the MetS.</p> </sec> <sec id="joim12051-sec-0004" sec-type="section"> <title>Results</title> <p>During follow‐up, 428 subjects developed new‐onset MetS. In age‐ and sex‐adjusted analysis, compared with the lowest quartile of cystatin C, the odds ratios (95% confidence interval) for incident MetS in subjects with cystatin C levels in quartiles 2, 3 and 4 were 1.00 (0.71–1.40), 1.48 (1.06–2.07) and 1.91 (1.37–2.68), respectively (<italic>P</italic><sub>trend</sub> < 0.001); this linear association remained significant even after full multivariate adjustment (<italic>P</italic><sub>trend</sub> = 0.041). Interestingly, in this fully adjusted model, long‐term progression of abdominal obesity was the only component of the MetS significantly associated with increasing quartiles of baseline cystatin C levels (<italic>P</italic><sub>trend</sub> = 0.008).</p> </sec> <sec id="joim12051-sec-0005" sec-type="section"> <title>Conclusion</title> <p>These findings suggest that cystatin C may adversely affect metabolic factors, particularly abdominal obesity, thus contributing to development of the MetS. Our results may help to explain the link between cystatin C and development of CVD.</p> </sec> </abstract>