Abstract 4061: Association of Cystatin-C with Cardiovascular Disease Risk Factors: The Framingham Offspring Cohort
Background:Cystatin C (cysC) is a novel marker for kidney function that predicts cardiovascular disease (CVD). We sought to develop cysC cutpoints and to examine the association of CVD risk factors and chronic kidney disease (CKD) in persons with high cysC.
Methods:Among Framingham Offspring who attended the seventh examination cycle (1998–2001; n=3242, mean age=61 years, 54% women) sex-specific 95th percentile cutpoints were developed for cysC in a healthy referent subset (n=746) after excluding persons with diabetes, hypertension, smoking, triglycerides≥150 mg/dl, lipid treatment HDL < 40 mg/dl in men and 50 in women, obesity and prevalent CVD. After applying these cutpoints back to the overall broad sample, multiple logistic regression was used to evaluate the association between CVD risk factors and cysC>95th%ile sex-specific referent sample threshold. Glomerular filtration rate (GFR) was estimated using the simplified MDRD study equation. CKD was defined as GFR <59 ml/min/1.73 m2 in women and <64 in men.
Results: In women, the 95th percentile cutpoint was 1.05 mg/L, whereas in men it was 1.12 mg/L, resulting in 628 individuals with high cysC. Among the broad sample, with both age and sex forced into the statistical model, increasing age, hypertension treatment, current cigarette smoking, BMI, prevalent CVD, and lower diastolic blood pressure and HDL cholesterol, were associated with high cysC (Table⇓). Only 37% of persons with high cysC had CKD whereas 71% of those with CKD had high cysC.
Conclusions: High cysC is associated with known CVD risk factors. Whether cysC can improve the estimation of glomerular filtration rate, CKD and prognosis in the community remains to be determined.