Key result
High cystatin C levels were associated with an 8.0% (95% CI 2.2 to 14.1%) higher aortic pulse wave velocity compared to low cystatin C levels in older adults.
Why the study?
Does elevated cystatin C associate with increased aortic pulse wave velocity in older adults?
Observational (n=2,468)
Does elevated cystatin C associate with increased aortic pulse wave velocity in older adults?
Effect estimate: 8.0% higher aPWV (high vs low cystatin C) (95% CI 2.2 to 14.1)
Higher cystatin C levels, but not eGFR <60 ml/min per 1.73 m2, are associated with increased arterial stiffness in older adults, suggesting a potential mechanism for cardiovascular risk in early kidney disease.
May link early kidney dysfunction to stiffness beyond eGFR; hypothesis-generating for CV mechanisms, needs longitudinal confirmation.
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.
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Madero et al. (2009) conducted an observational in Arterial stiffness (n=2,468). Medium and high cystatin C levels vs. Low cystatin C level was evaluated on Aortic pulse wave velocity (aPWV) (8.0% higher aPWV (high vs low cystatin C), 95% CI 2.2 to 14.1). High cystatin C levels were associated with an 8.0% (95% CI 2.2 to 14.1%) higher aortic pulse wave velocity compared to low cystatin C levels in older adults.