title: High levels of cystatin C predict the metabolic syndrome: the prospective Malmö Diet and Cancer Study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  Metabolic syndrome and long-term progression as well as incidence of the different components of the MetS.
  
  
  RESULTS
  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 (Ptrend  < 0.001); this linear association remained significant even after full multivariate adjustment (Ptrend  = 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 (Ptrend  = 0.008).
  
  
  CONCLUSIONS
  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.
authors: Department of Clinical Sciences, Lund University, Malmö, Sweden. martin.magnusson@med.lu.se
authors: M
authors: M
authors: Magnusson
authors: B
authors: B
authors: Hedblad
authors: G
authors: G
authors: Engström
authors: M
authors: M
authors: Persson
authors: P
authors: P
authors: Nilsson
authors: O
authors: O
authors: Melander
mesh_terms: D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D016022:Case-Control Studies; D016001:Confidence Intervals; D055316:Cystatin C / Q000097:blood* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
chemical_list: D015415:Biomarkers; D055316:Cystatin C
keywords: abdominal obesity; cystatin C; metabolic syndrome