Cystatin C and aging success
Cystatin C and aging success
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DOI：
10.1001/archinternmed.2007.40
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发表时间：
2008-01-28
影响因子：
--
通讯作者：
Shlipak, Michael G.
中科院分区：
文献类型：
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作者：
Sarnak, Mark J.;Katz, Ronit;Shlipak, Michael G.
背景：据我们所知，肾功能对成功衰老的影响尚未被研究过。方法：我们在心血管健康研究中评估了胱抑素C与衰老成功之间的关系，这是一个基于社区的老年人队列（年龄>= 65岁）。成功衰老的定义是没有心血管疾病、癌症和慢性阻塞性肺病，身体和认知功能完好。在调整后的分析中，使用加速失效时间模型来评估胱抑素C水平对成功年减少的百分比。一个单独的Cox比例风险模型评估胱抑素C是否与发生的身体和认知残疾有关。结果：共有2140名参与者测量了胱抑素C，并且在基线时没有上述情况。他们的平均年龄为74岁。平均胱抑素C水平、肌酐水平和估计肾小球滤过率分别为1.06 mg/L、0.93 mg/dL和78 mL/min/1.73 m(2)（将胱抑素C转换为纳摩尔/升，乘以75；将肌酐转换为微摩尔/升，乘以88.4）。共有873名参与者在随访中达到第一次事件，138人因认知残疾，238人因身体残疾，34人因慢性阻塞性肺病。146人死于癌症317人死于心血管疾病胱抑素C最高和最低四分位数的调整后成功寿命年减少百分比为27%（95%置信区间，11%-39%）。胱抑素C的最高和最低四分位数也与认知或身体残疾事件独立相关（风险比，1.39；95%可信区间，1.00-1.98）。结论：较高的胱抑素C水平，即使在肾功能相对正常的范围内，也与不成功的衰老有关。
Background: To our knowledge, the effect of kidney function on successful aging has not been examined.Methods: We evaluated the relationship between cystatin C and aging success during a 6-year follow-up in the Cardiovascular Health Study, a community-based cohort of older adults (aged >= 65 years). Successful aging was defined as remaining free of cardiovascular disease, cancer, and chronic obstructive pulmonary disease and having intact physical and cognitive functioning. In adjusted analysis, an accelerated failure time model was used to evaluate the percentage reduction in successful years by level of cystatin C. A separate Cox proportional hazards model evaluated whether cystatin C was related to incident physical and cognitive disability.Results: A total of 2140 participants had cystatin C measured and were free of the previously mentioned conditions at baseline. Their mean age was 74 years. The mean cystatin C level, creatinine level, and estimated glomerular filtration rate were 1.06 mg/L, 0.93 mg/dL, and 78 mL/min/1.73 m(2), respectively (to convert cystatin C to nanomoles per liter, multiply by 75; and to convert creatinine to micromoles per liter, multiply by 88.4). A total of 873 participants reached a first event in follow-up, 138 because of cognitive disability, 238 because of physical disability, 34 because of chronic obstructive pulmonary disease,.146 because of cancer, and 317 because of cardiovascular disease. The adjusted percentage reduction in successful life years in the highest vs the lowest quartile of cystatin C was 27% (95% confidence interval, 11%-39%). The highest vs lowest quartile of cystatin C also was independently associated with incident cognitive or physical disability (hazard ratio, 1.39; 95% confidence interval, 1.00-1.98).Conclusions: A higher cystatin C level, even within a range of relatively normal kidney function, was associated with unsuccessful aging.