Cystatin-C, renal function, and incidence of hip fracture in postmenopausal women.
Cystatin-C, renal function, and incidence of hip fracture in postmenopausal women.
复制标题
DOI：
10.1111/j.1532-5415.2008.01807.x
复制
发表时间：
2008-08
影响因子：
6.3
通讯作者：
Women's Health Initiative Observational
中科院分区：
文献类型：
--
作者：
LaCroix AZ;Lee JS;Wu L;Cauley JA;Shlipak MG;Ott SM;Robbins J;Curb JD;Leboff M;Bauer DC;Jackson RD;Kooperberg CL;Cummings SR;Women's Health Initiative Observational
使用血清胱抑素C作为肾功能生物标志物（不参考肌肉质量）评估慢性肾脏疾病与髋部骨折的相关性。前瞻性研究中嵌套的病例对照研究。在美国40个临床中心进行的妇女健康倡议观察性研究。对93，676名年龄在50-79岁之间的女性进行了平均7年的随访，其中397名发生髋部骨折的病例和397名匹配的对照进行了研究。使用颗粒增强免疫肾测定法测量基线血清中的胱抑素C水平。用经验证的方程计算估计的肾小球滤过率（eGFRcys-c），并分为三组：1）eGFRcys-c >90 mL/min/1.73 m2; 2）eGFRcys-c 60-90 mL/min/1.73 m2;或3）eGFRcys-c <60 mL/min/1.73 m2，表明慢性肾病3-4期。校正体重、父母髋部骨折、吸烟、饮酒和身体功能后，eGFRcys-c <60 ml/min/1.73 m2与0-1期相比，髋部骨折的比值比（OR）为2.50（95%置信区间（CI）1.32-4.72）。eGFRcys-c 60-90 mL/min/1.73 m2未观察到相关性（OR=1.04; CI 0.66-1.64）。这些关联不受额外调整不良健康状况、血红蛋白、血清25羟维生素D或骨代谢标志物的影响。校正血浆同型半胱氨酸后，eGFRcys-c <60 mL/min/1.73 m2的OR降至1.83（CI 0.93-3.61）。cystatin-C eGFR水平<60的女性髋部骨折的风险显著增加。这种关联可能部分介导，或伴随着肾功能对同型半胱氨酸水平的影响。
To evaluate the association of chronic kidney disease with incident hip fracture using serum cystatin-C as a biomarker of renal function calculated without reference to muscle mass. Case-control study nested within a prospective study. The Women’s Health Initiative Observational Study conducted at 40 US clinical centers. From 93,676 women ages 50–79 years followed for an average of 7 years, 397 incident hip fracture cases and 397 matched controls were studied. Cystatin-C levels were measured on baseline serum using a particle-enhanced immunonepholometric assay. Estimated glomerular filtration rates (eGFRcys-c) were calculated with a validated equation and categorized into three groups: 1) eGFRcys-c >90 mL/min/1.73 m2; 2) eGFRcys-c 60–90 mL/min/1.73 m2; or 3) eGFRcys-c <60 mL/min/1.73 m2 indicating chronic kidney disease Stages 3–4. The odds ratio (OR) for hip fracture was 2.50 (95% confidence interval (CI) 1.32–4.72) for eGFRcys-c <60 ml/min/1.73 m2 compared to Stages 0–1 after adjustment for body mass, parental hip fracture, smoking, alcohol consumption and physical function. No association was observed for eGFRcys-c 60–90 mL/min/1.73 m2 (OR=1.04; CI 0.66–1.64). These associations were unaffected by additional adjustment for poor health status, hemoglobin, serum 25hydroxyvitamin D, or bone metabolism markers. Adjustment for plasma homocysteine reduced the OR for eGFRcys-c <60 mL/min/1.73 m2 to 1.83 (CI 0.93–3.61). Women with cystatin-C eGFR levels <60 have a substantially increased risk of hip fracture. This association may be partially mediated, or accompanied by, effects of renal function on homocysteine levels.
登录
查看更多内容
影响因子：
6.2
作者：
Gjesdal, Clara Gram;Vollset, Stein Emil;Tell, Grethe S.
通讯作者：
Tell, Grethe S.
影响因子：
13.2
作者：
Stevens, Lesley A.;Coresh, Josef;Levey, Andrew S.
通讯作者：
Levey, Andrew S.
影响因子：
13.2
作者：
Coco, M;Rush, H
通讯作者：
Rush, H
影响因子：
4
作者：
Dukas, L;Schacht, E;Stähelin, HB
通讯作者：
Stähelin, HB
影响因子：
13.6
作者：
Nickolas, Thomas L.;McMahon, Donald J.;Shane, Elizabeth
通讯作者：
Shane, Elizabeth