Serum cystatin C in the United States:: The Third National Health and Nutrition Examination Survey (NHANES III)
Serum cystatin C in the United States:: The Third National Health and Nutrition Examination Survey (NHANES III)
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DOI：
10.1053/j.ajkd.2007.11.019
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发表时间：
2008-03-01
影响因子：
13.2
通讯作者：
Coresh, Josef
中科院分区：
文献类型：
--
作者：
Koettgen, Anna;Selvin, Elizabeth;Coresh, Josef
背景：血清胱抑素C越来越多地被用作肾小球滤过率和心血管风险的标志物。然而，缺乏一般人群，特别是广泛年龄范围和不同种族的血清半胱氨酸蛋白酶抑制剂C水平的信息。目的：确定全国代表性的血清半胱氨酸蛋白酶抑制剂C水平，估计一般人群中半胱氨酸蛋白酶抑制剂C水平升高的患病率，并确定与半胱氨酸蛋白酶抑制剂C水平升高相关的因素。研究设计：横断面调查。设置和参与者：在1988- 1994年进行的第三次全国健康和营养检查调查中，7，596名年龄在12岁或以上的参与者的全国代表性子样本。预测因素：年龄、性别、种族/民族、慢性肾脏疾病的危险因素。结果：连续血清胱抑素C水平和血清胱抑素C水平大于1。12毫克/升。2006年采用自动化粒子增强散射比浊法测定了储存血清中的胱抑素C。中位胱抑素C水平随着年龄的增长而急剧增加，在男性和非西班牙裔白色人中更高，甚至在20- 39岁的健康亚组中也是如此。在所有年龄小于20岁、60岁或以上和80岁或以上的人群中，血清胱抑素C水平升高（>1.1 2 mg/L）的患病率分别为1%、41%和大于50%。在60岁及以上的人群中，老年人、非西班牙裔白色种族、高血压、当前吸烟、教育水平和高密度脂蛋白胆固醇水平较低、体重指数、C反应蛋白和甘油三酯值升高与血清胱抑素C水平升高显著相关。局限性：未测量肾小球滤过率、单次测量胱抑素C、横断面研究设计。血清胱抑素C水平与性别和种族有关，即使在年轻健康个体中也是如此。随着年龄的增长，胱抑素C水平升高的患病率急剧增加，在80岁后，男女和所有种族人群中均达到50%以上。
Background: Serum cystatin C increasingly is used as a marker of glomerular filtration rate and cardiovascular risk. However, information for serum cystatin C levels in the general population, specifically across a wide age range and different ethnicities, is lacking.Objectives: To determine nationally representative serum cystatin C levels, estimate the prevalence of increased cystatin C levels in the general population, and identify factors associated with increased cystatin C levels.Study Design: Cross-sectional survey.Setting and Participants: A nationally representative subsample of 7,596 participants aged 12 years or older in the Third National Health and Nutrition Examination Survey conducted in 1988-1994.Predictors: Age, sex, race/ethnicity, risk factors for chronic kidney disease.Outcomes: Continuous serum cystatin C levels and serum cystatin C level greater than 1. 12 mg/L.Measurements: Cystatin C was measured in 2006 from stored sera by using an automated particle-enhanced nephelometric assay.Results: Overall median serum cystatin C level was 0.85 mg/L. Median cystatin C levels increased steeply with age and were greater in males and non-Hispanic white persons, even in a healthy subgroup of 20- to 39-year-olds. Prevalences of increased serum cystatin C levels (>1.1 2 mg/L) were 1%, 41 %, and greater than 50% in all persons aged younger than 20 years, 60 years or older, and 80 years or older. In persons aged 60 years and older, older age, non-Hispanic white ethnicity, hypertension, current smoking, lower levels of education and high-density lipoprotein cholesterol, and increased body mass index, C-reactive protein, and triglyceride values were associated significantly with increased serum cystatin C levels.Limitations: No measured glomerular filtration rate, single measurement of cystatin C, cross-sectional study design.Conclusions: Serum cystatin C level is related to sex and ethnicity, even in young healthy individuals. The prevalence of increased cystatin C levels increases dramatically with age, reaching greater than 50% after the age of 80 years in both sexes and all ethnic groups.