NDT Advance Access originally published online on January 5, 2007
Nephrology Dialysis Transplantation 2007 22(4):1107-1114; doi:10.1093/ndt/gfl733
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Microalbuminuria, but not cystatin C, is associated with carotid atherosclerosis in middle-aged adults
1Department of Community Medicine and Public Health, Cardiovascular Prevention Clinic, University Outpatient Clinic, 2Department of Community Medicine and Public Health, University Institute of Social and Preventive Medicine, 3Department of Medicine, Division of Cardiology, University of Lausanne, Switzerland, 4Unit for Prevention and Control of CVD (UPCCD), Ministry of Health, Republic of Seychelles, 5Institute of Clinical Chemistry and Haematology, Kantonsspital, St-Gallen and 6Department of Medicine, Division of Nephrology, University of Lausanne, Switzerland.
Correspondence and offprint requests to: Nicolas Rodondi, MD, MAS, Cardiovascular Prevention Clinic, University Outpatient Clinic and University Institute of Social and Preventive Medicine, Department of Community Medicine and Public Health, University of Lausanne, Bugnon 44, 1011 Lausanne, Switzerland. Email: Nicolas.Rodondi{at}hospvd.ch
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Abstract |
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Background. Cystatin C, a marker of renal function, has been shown to be an independent predictor of cardiovascular disease (CVD) in older adults, but few data are available in middle-aged adults. Moreover, no study has compared cystatin C and microalbuminuria as risk factors for CVD outcomes in middle-aged adults, and it is not known whether cystatin C is related to an early stage of atherosclerosis.
Methods. We evaluated the relationships between serum creatinine, estimated glomerular filtration rate (GFR), serum cystatin C (all divided into tertiles), microalbuminuria and carotid atherosclerosis in a population-based random sample of 523 adults aged 35–64 years from the Seychelles (Indian Ocean). GFR was estimated using the modification of diet in renal disease (MDRD) equation. Intima-media thickness (IMT) was assessed by B-mode ultrasound.
Results. The mean age of the study sample was 52 years, and 55% were women. Carotid IMT was higher in participants with microalbuminuria (802 vs 732 µm, P < 0.001) and was inversely associated with GFR tertiles (from 728 to 809 µm, P for trend = 0.002). IMT was not associated with cystatin C or creatinine (P for trend = 0.10 and 0.16, respectively). In multivariate analyses adjusted for cardiovascular risk factors, the association between microalbuminuria and IMT remained (P = 0.047), while the association between GFR and IMT disappeared (P for trend = 0.33).
Conclusions. Microalbuminuria, but not cystatin C, is associated with carotid atherosclerosis beyond traditional cardiovascular risk factors among middle-aged adults. Cystatin C does not have a stronger relationship with carotid atherosclerosis in middle-aged adults than creatinine.
Keywords: Africa; albuminuria; atherosclerosis; cystatin; Seychelles
Received for publication: 13. 8.06
Accepted in revised form: 9.11.06
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