Cystatin C associates with arterial stiffness in older adults.
Large arteries commonly become stiff in kidney failure, but few studies have investigated arterial stiffness in earlier stages of kidney disease. We evaluated the association between kidney function and aortic pulse wave velocity (aPWV) and its potential modification by race, diabetes, or coronary heart disease in older adults. We measured aPWV in 2468 participants in the Health Aging and Body Composition (Health ABC) study; mean age was 73.7 yr, 40% were black, and 24% had diabetes. After categorizing kidney function into three groups on the basis of cystatin C level, multivariable analysis revealed that the medium and high cystatin C groups associated with a 5.3% (95% confidence interval 0.8 to 10.0%) and 8.0% (95% confidence interval 2.2 to 14.1%) higher aPWV than the low cystatin C group; however, chronic kidney disease, as defined by estimated GFR <60 ml/min per 1.73 m(2), did not significantly associate with aPWV. We did not identify interactions between cystatin C and race, diabetes, or coronary heart disease. In conclusion, stiffness of large arteries, a major risk factor for cardiovascular disease, may partially mediate the association between cystatin C and cardiovascular risk in older adults.
Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez México City, Mexico.
Magdalena
M
Madero
Christina L
CL
Wassel
Carmen A
CA
Peralta
Samer S
SS
Najjar
Kim
K
Sutton-Tyrrell
Linda
L
Fried
Robert
R
Canada
Anne
A
Newman
Michael G
MG
Shlipak
Mark J
MJ
Sarnak
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000453:epidemiology*; D001158:Arteries / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity / Q000502:physiology*; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D055316:Cystatin C / Q000378:metabolism*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D016491:Peripheral Vascular Diseases / Q000453:epidemiology*; D011674:Pulse; D051437:Renal Insufficiency / Q000453:epidemiology; D012307:Risk Factors
D015415:Biomarkers; D055316:Cystatin C