Correlation between serum cystatin C and markers of subclinical atherosclerosis in hypertensive patients

• Published in: Arquivos brasileiros de cardiologia 2012-10, Vol.99 (4), p.899-906
• Main Authors: Monteiro Junior, Francisco das Chagas, Ferreira, Pedro Antônio Muniz, Nunes, José Aldemir Teixeira, Cunha Júnior, Cacionor Pereira da, Brito, Ronald Lopes, Costa, João Henrique Almeida, Lima, José Ribamar Oliveira, Lages, Joyce Santos, Salgado Filho, Natalino, Lima, Valter Correia de
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Atherosclerosis - blood; Atherosclerosis - diagnosis; Biomarkers - blood; Brachial Artery - physiopathology; Carotid Intima-Media Thickness; Creatinine - blood; Cross-Sectional Studies; Cystatin C - blood; Female; Humans; Hypertension - blood; Hypertension - physiopathology; Kidney - physiopathology; Male; Middle Aged; Risk Factors
• ISSN: 1678-4170
• DOI: 10.1590/S0066-782X2012005000083

Serum cystatin C (s-CC), an endogenous marker of kidney function, has also been proposed as a cardiovascular risk marker. However, it is unknown whether it is a direct marker of atherosclerosis, independently of kidney function. The aim of this study was to correlate s-CC with two surrogate markers of subclinical atherosclerosis. This is a cross-sectional study involving 103 middle-aged (57.49 ± 11.7 years) hypertensive outpatients, being 60 female (58.25%), most with preserved kidney function. S-CC was correlated with carotid intima media thickness (IMT) and flow-mediated dilation of brachial artery (FMD), both assessed by ultrasound, as well as with measured creatinine clearance and established cardiovascular risk factors. S-CC was neither significantly correlated with IMT (r = -0.024; p = 0.84) nor with FMD (r = -0.050 and p = 0.687) and no significant association was observed with conventional risk factors and inflammatory markers. In univariate analysis, s-CC was correlated with measured creatinine clearance (r = -0,498; p < 0,001), age (r = 0,408; p < 0,001), microalbuminuria (r = 0,291; p = 0,014), uric acid (r = 0,391; p < 0,001), ratio E/e' (r = 0,242; p = 0,049) and Framingham score (r = 0,359; p = 0,001). However, after multiple regression analysis, only the association with measured creatinine clearance remained significant (r = -0,491; p < 0,001). In middle-aged hypertensive outpatients, s-CC correlated with measured creatinine clearance, as expected, but no association was observed with markers of atherosclerosis neither with established cardiovascular risk factors.