Cystatin C, renal function, and atherosclerosis in rheumatoid arthritis.

Lertnawapan R, Bian A, Rho YH, Kawai VK, Raggi P, Oeser A, Solus JF, Gebretsadik T, Shintani A, Stein CM
J Rheumatol. 2011 38 (11): 2297-300

PMID: 21844147 · PMCID: PMC3207028 · DOI:10.3899/jrheum.110168

OBJECTIVE - We examined the hypothesis that cystatin C, a novel marker of renal function, is elevated in rheumatoid arthritis (RA) and is associated with inflammation and coronary atherosclerosis.

METHODS - We measured serum cystatin C, creatinine, tumor necrosis factor-α and interleukin 6 concentrations, coronary artery calcium score (CACS), and Modified Diet in Renal Disease estimated glomerular filtration rate in 167 patients with RA and 91 controls.

RESULTS - Cystatin C was higher in RA patients [median (IQR) 1.16 (0.99-1.35) mg/l] than controls [1.01 (0.90-1.19) mg/l; p < 0.001] and correlated positively with erythrocyte sedimentation rate (p < 0.001), C-reactive protein (p = 0.01), 28-joint Disease Activity Score (p = 0.006), and Framingham risk score (FRS; p = 0.02). Cystatin C was correlated with CACS (p < 0.001) in RA, but this was not significant after adjustment for age, race, sex, and FRS (p = 0.44).

CONCLUSION - Cystatin C concentrations are higher in RA than controls and may reflect inflammation and undetected subclinical renal dysfunction. Cystatin C provides information regarding the risk of atherosclerosis in RA, but this is not independent of the information provided by conventional cardiovascular risk factors.

MeSH Terms (19)

Adult Aged Arthritis, Rheumatoid Biomarkers Calcium Case-Control Studies Coronary Artery Disease Coronary Vessels Creatinine Cystatin C Female Glomerular Filtration Rate Humans Interleukin-6 Kidney Male Middle Aged Risk Factors Tumor Necrosis Factor-alpha

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