title: Association between high cystatin C levels and carotid atherosclerosis.
abstract: OBJECTIVE
  To investigate the association between carotid atherosclerosis and cystatin C (CysC) and to determine the optimal CysC cut-off value.
  
  
  METHODS
  One hundred twenty-eight subjects were included in this study. Atherosclerosis was defined as a maximum carotid plaque thickness (MCPT) of greater than 2 mm. A receiver operating characteristic curve analysis was used to determine the diagnostic value of serum CysC for atherosclerosis. The subjects were divided into two groups according to the CysC cut-off value. We screened for diabetes, hypertension, dyslipidemia, smoking status, alcohol consumption, and exercise behavior. The association between atherosclerosis and CysC levels was assessed using multivariate analysis.
  
  
  RESULTS
  The subjects were then divided into two groups according to the CysC cut-off value (0.73 mg/L). The median age of the high CysC group was 72 years (85% males), whereas that of the low CysC group was 61 years (63% males). The CysC levels were significantly correlated with Cr and estimated glomerular filtration rate (eGFR) values. Body-mass index, visceral fat area, hypertension, diabetes mellitus, and MCPT were significantly higher in the high CysC group than in the low CysC group. Furthermore, the eGFR was significantly lower in the high CysC group. Regarding lifestyle habits, only the exercise level was lower in the high CysC group than in the low CysC group. Multivariate analysis, adjusted for age and sex, revealed that high CysC levels were significantly associated with an MCPT of ≥ 2 mm (odds ratio: 2.92; 95%CI: 1.13-7.99).
  
  
  CONCLUSIONS
  Higher CysC levels were associated with an MCPT of ≥ 2 mm. The CysC cut-off value of 0.73 mg/L appears to aid in the diagnosis of atherosclerosis.
authors.affiliation: Toshiyuki Kobayashi, Department of General Medicine, Zama General Hospital, Kanagawa 252-0011, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Toshiyuki Kobayashi, Department of General Medicine, Zama General Hospital, Kanagawa 252-0011, Japan.
authors.forename: Hirohide
authors.initials: H
authors.lastname: Yokokawa
authors.affiliation: Toshiyuki Kobayashi, Department of General Medicine, Zama General Hospital, Kanagawa 252-0011, Japan.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Fujibayashi
authors.affiliation: Toshiyuki Kobayashi, Department of General Medicine, Zama General Hospital, Kanagawa 252-0011, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Haniu
authors.affiliation: Toshiyuki Kobayashi, Department of General Medicine, Zama General Hospital, Kanagawa 252-0011, Japan.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Hisaoka
authors.affiliation: Toshiyuki Kobayashi, Department of General Medicine, Zama General Hospital, Kanagawa 252-0011, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukuda
authors.affiliation: Toshiyuki Kobayashi, Department of General Medicine, Zama General Hospital, Kanagawa 252-0011, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Naito
keywords: Atherosclerosis; Carotid plaque; Cystatin C; Maximum carotid plaque thickness; Visceral fat