Association of cystatin C with adverse outcomes.
Association of cystatin C with adverse outcomes.
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DOI：
10.1097/mnh.0b013e328326f3dd
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发表时间：
2009-05
影响因子：
3.2
通讯作者：
Sarnak MJ
中科院分区：
文献类型：
--
作者：
Madero M;Sarnak MJ
讨论最近评估胱抑素C决定因素的研究，并重点关注胱抑素C与死亡率、心血管疾病（CVD）和非心血管结局的关系。在慢性肾脏疾病流行病学研究中，胱抑素C与独立于测量的肾小球滤过率（GFR）的人口学特征相关，尽管其程度小于肌酐。在已确诊的CKD患者中，胱抑素C与测量的GFR呈强烈负相关，这表明尽管胱抑素C可能有其他决定因素，但它主要是肾功能的测量指标。一些队列研究，特别是在老年人中，现在已经证明胱抑素C与死亡率、心血管疾病和非心血管疾病结局呈线性相关，而肌酐主要与晚期肾病患者的风险相关。最近的一项研究也表明，由胱抑素C测定的肾功能变化，即使在相对正常的范围内，也与老年人随后的心血管疾病和全因死亡率有关。半胱抑素C似乎捕捉到轻度肾脏疾病与死亡率、CVD和非CVD结局风险增加的关联。未来的研究应该评估胱抑素C是否可以改善医疗决策并导致良好的患者预后。
To discuss recent studies which have evaluated determinants of cystatin C and to focus on the relationship of cystatin C with mortality, cardiovascular disease (CVD) and non-cardiovascular outcomes. In the Chronic Kidney Disease Epidemiology Study cystatin C was associated with demographic characteristics independent of measured glomerular filtration rate (GFR), although this was to a smaller extent than creatinine. In patients with established CKD, cystatin C was strongly and inversely correlated with measured GFR, suggesting that although cystatin C may have other determinants, it is primarily a measure of kidney function. Several cohort studies, particularly in older adults, have now demonstrated that cystatin C is linearly associated with mortality, CVD and non-CVD outcomes, whereas creatinine is primarily associated with risk in individuals with more advanced kidney disease. A recent study has also shown that changes in kidney function as ascertained by cystatin C, even within the relatively normal range, are associated with subsequent CVD and all-cause mortality among older adults. Cystatin C appears to capture an association of mild kidney disease with increased risk of mortality, CVD and non-CVD outcomes. Future studies should evaluate whether cystatin C can improve medical decision-making and lead to favorable patient outcomes.
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