title: Serum cathepsin S and cystatin C: relationship to subclinical carotid atherosclerosis in rheumatoid arthritis.
abstract: OBJECTIVE
  To assess whether serum cathepsin S and cystatin C, two novel markers of cardiovascular disease risk, are associated with subclinical carotid atherosclerosis in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Serum cystatin C and cathepsin S levels, carotid intima-media thickness (cIMT) and carotid plaques were assessed in a cross-sectional study involving 178 RA patients.
  
  
  RESULTS
  An association between disease activity scores with higher levels of cystatin C, but not with cathepsin S, was found. Cystatin C levels were also associated with cIMT in the patient subgroup included in the higher quartile of Cimt (OR 1.31, 95%CI [1.00-1.72], p=0.04) after adjusting for traditional cardiovascular risk factors, age and sex. An association between serum cystatin C levels and carotid plaques was also found in the univariate analysis (OR 1.37, 95%CI [1.06-1.76], p=0.02). However, this significant association was lost after adjusting for traditional cardiovascular risk factors and age. Cathepsin S was not associated with cIMT or carotid plaques.
  
  
  CONCLUSIONS
  High cystatin C serum levels identify a subgroup of RA patients with a high risk of subclinical atherosclerotic disease.
authors.affiliation: Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Tejera-Segura
authors.affiliation: Central Laboratory Division, Hospital Universitario de Canarias, Tenerife, Spain.
authors.forename: Antonia M
authors.initials: AM
authors.lastname: de Vera-González
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Division of Rheumatology, IDIVAL, Santander, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: López-Mejías
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain; and University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: González-Gay
authors.affiliation: Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain. iferrazamaro@hotmail.com.
authors.forename: Ivan
authors.initials: I
authors.lastname: Ferraz-Amaro
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications*; D002340:Carotid Artery Diseases / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D002403:Cathepsins / Q000097:blood*; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D055316:Cystatin C; D002403:Cathepsins; C028217:cathepsin S