High levels of cystatin C predict the metabolic syndrome: the prospective Malmö Diet and Cancer Study
Article first published online: 4 MAR 2013
© 2013 The Association for the Publication of the Journal of Internal Medicine
Journal of Internal Medicine
Volume 274, Issue 2, pages 192–199, August 2013
How to Cite
Lund University, Malmö, Sweden; Skåne University Hospital, Malmö, Sweden; Skåne University Hospital, Malmö, Sweden High levels of cystatin C predict the metabolic syndrome: the prospective Malmö Diet and Cancer Study. J Intern Med 2013; 274: 192–199., , , , ,
- Issue published online: 12 JUL 2013
- Article first published online: 4 MAR 2013
- Accepted manuscript online: 18 FEB 2013 03:15AM EST
- Swedish Medical Research Council. Grant Numbers: K2009-64X-20129-04-3, K2009-64X-20129-04-3, 2007-2533, 2010-2917, 2011-3891, StG-282255
- Hulda and Conrad Mossfelt Foundation
- King Gustaf V and Queen Victoria Foundation
- Lennart Hanssons Memorial Fund
- Knut and Alice Wallenberg Foundation
- Marianne and Marcus Wallenberg Foundation
- Southwest Skånes Diabetes Foundation. Grant Number: StG-282255
- European Research Council. Grant Number: StG-282255
- Swedish Heart and Lung Foundation
- Medical Faculty of Lund University
- Skåne University Hospital
- Albert Påhlsson Research Foundation
- Crafoord Foundation
- Ernhold Lundströms Research Foundation
- Skane county council′s research and development foundation
- abdominal obesity;
- cystatin C;
- metabolic syndrome
Cystatin C is a novel marker of cardiovascular disease (CVD); however, the underlying mechanisms remain unclear. Here, we prospectively investigated whether plasma levels of cystatin C predict new-onset metabolic syndrome (MetS) as well as long-term progression and incidence of the different components of the MetS.
Cystatin C was measured in 1502 individuals included in the Malmö Diet and Cancer cardiovascular cohort (mean age 56 years, 59% women) who were free from the MetS at baseline and subsequently underwent a follow-up examination after a median of 16 years. MetS was defined according to the NCEP-ATP-III guidelines. Logistic regression was used to adjust for covariates.
Main outcome measures
Metabolic syndrome and long-term progression as well as incidence of the different components of the MetS.
During follow-up, 428 subjects developed new-onset MetS. In age- and sex-adjusted analysis, compared with the lowest quartile of cystatin C, the odds ratios (95% confidence interval) for incident MetS in subjects with cystatin C levels in quartiles 2, 3 and 4 were 1.00 (0.71–1.40), 1.48 (1.06–2.07) and 1.91 (1.37–2.68), respectively (Ptrend < 0.001); this linear association remained significant even after full multivariate adjustment (Ptrend = 0.041). Interestingly, in this fully adjusted model, long-term progression of abdominal obesity was the only component of the MetS significantly associated with increasing quartiles of baseline cystatin C levels (Ptrend = 0.008).
These findings suggest that cystatin C may adversely affect metabolic factors, particularly abdominal obesity, thus contributing to development of the MetS. Our results may help to explain the link between cystatin C and development of CVD.