Cystatin C Is a Predictor for Long-Term, All-Cause, and Cardiovascular Mortality in US Adults With Metabolic Syndrome

Song, Xiaoying1; Xiong, Lijiao2,3; Guo, Tianting4; Chen, Xue2,3,5; Zhang, Pinjun6; Zhang, Xiaoan4; Liang, Zhen2,3,5

2024-04-01

10.1210/clinem/dgae225

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM   影响因子和分区

0021-972X

1945-7197

Objective: This study examined the relationship between cystatin C (CysC) levels and all-cause, cardiovascular disease (CVD), and cancer mortality in US metabolic syndrome (MetS) patients. Methods: The 1999-2002 National Health and Nutrition Examination Survey (NHANES) prospective cohort research included 1980 MetS participants. To assess CysC levels and all-cause, CVD, and cancer mortality, fitted curves, Kaplan-Meier survival curves, Cox regression analysis, and receiver operating characteristic curves were performed. Results: During a mean follow-up of 15.3 +/- 5.4 years, a total of 819 deaths occurred. The fitted and Kaplan-Meier survival curves revealed that greater CysC levels were linked to higher all-cause, CVD, and cancer mortality rates (P < .05). After adjusting for variables, CysC level was associated with all-cause, CVD, and cancer mortality at 1.63 (1.42-1.88), 1.53 (1.19-1.95), and 1.53 (1 similar to 2.32), respectively (P < .05). Tertile models showed consistent results: high CysC Tertile participants showed higher risk of all-cause mortality (HR 1.87; 1.43-2.45), CVD mortality (HR 1.97, 1.15 similar to 3.38), and cancer mortality (HR 1.72, 1.01 similar to 2.91) compared to those in the lowest tertile (P < .05). Subgroup studies by sex and other characteristics confirmed the findings. CysC demonstrated the higher predictive efficacy across mortality outcomes, followed by eGFR, outperforming urea nitrogen, creatinine, uric acid, and C-reactive protein. CysC alone exhibited substantial predictive value for all-cause (AUC 0.773; P < .05) and CVD mortality (AUC 0.726; P < .05). Combining CysC with age enhanced predictive value for all-cause mortality to 0.861 and CVD mortality to 0.771 (P < .05). Conclusion: MetS patients with elevated CysC levels have a higher risk of all-cause, CVD, and cancer death. CysC may predict MetS all-cause and CVD mortality.

Cystatin C metabolic syndrome all-cause mortality CVD mortality cancer mortality prognostic marker

SCI

英语

通讯

Shenzhen Scientific and Technological Foundation["JCYJ20200109142610136","KCXFZ20201221173600001"] ; Jiangxi Provincial Department of Science and Technology["2020A0042","2021A374"] ; Health Commission of Jiangxi Province[202312146] ; Bureau of Science and Technology of Ganzhou Municipality[2023LNS26841]

Endocrinology & Metabolism

Endocrinology & Metabolism

WOS:001207877900001

ENDOCRINE SOC

CLINICAL MEDICINE

Web of Science

1.Ganzhou Peoples Hosp, Med Dept, Ganzhou 341000, Jiangxi, Peoples R China
2.Jinan Univ, Shenzhen Peoples Hosp, Clin Med Coll 2, Dept Geriatr, Guangzhou, Peoples R China
3.Southern Univ Sci & Technol, Affiliated Hosp 1, 017 North Dongmen Rd, Shenzhen 518000, Peoples R China
4.Ganzhou Hosp, Guangdong Prov Peoples Hosp, Ganzhou Municipal Hosp, 49 Dagong Rd, Ganzhou 341000, Jiangxi, Peoples R China
5.Jinan Univ, Shenzhen Peoples Hosp, Clin Med Coll 2, Guangdong Prov Clin Res Ctr Geriatr,Shenzhen Clin, Guangzhou, Peoples R China
6.Gannan Med Univ, 1 Med Univ Rd, Ganzhou 341000, Jiangxi, Peoples R China

Song, Xiaoying,Xiong, Lijiao,Guo, Tianting,et al. Cystatin C Is a Predictor for Long-Term, All-Cause, and Cardiovascular Mortality in US Adults With Metabolic Syndrome[J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM,2024.

Song, Xiaoying.,Xiong, Lijiao.,Guo, Tianting.,Chen, Xue.,Zhang, Pinjun.,...&Liang, Zhen.(2024).Cystatin C Is a Predictor for Long-Term, All-Cause, and Cardiovascular Mortality in US Adults With Metabolic Syndrome.JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM.

Song, Xiaoying,et al."Cystatin C Is a Predictor for Long-Term, All-Cause, and Cardiovascular Mortality in US Adults With Metabolic Syndrome".JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM (2024).