The Value of a Cystatin C-based Estimated Glomerular Filtration Rate for Cardiovascular Assessment in a General Japanese Population: Results From the Iwate Tohoku Medical Megabank Project

被引:4
|
作者
Osaki, Takuya [1 ,4 ]
Satoh, Mamoru [2 ,3 ,4 ,5 ]
Tanaka, Fumitaka [4 ,6 ]
Tanno, Kozo [4 ,7 ]
Takahashi, Yuji [1 ]
Nasu, Takahito [1 ]
Sakata, Kiyomi [4 ,7 ,8 ]
Morino, Yoshihiro [1 ]
Sobue, Kenji [9 ]
Sasaki, Makoto [8 ,10 ]
机构
[1] Iwate Med Univ, Dept Internal Med, Div Cardiol, Yahaba, Iwate, Japan
[2] Iwate Med Univ, Inst Biomed Sci, Div Biomed Informat Anal, 2-1-1 Nishitokuda, Yahaba, Iwate 0283694, Japan
[3] Iwate Med Univ, Div Biobank & Data Management, Iwate Tohoku Med Megabank Org, Yahaba, Iwate, Japan
[4] Iwate Med Univ, Div Clin Res & Epidemiol, Iwate Tohoku Med Megabank Org, Yahaba, Iwate, Japan
[5] Iwate Med Univ, Div Biomed Informat Anal, Iwate Tohoku Med Megabank Org, Yahaba, Iwate, Japan
[6] Iwate Med Univ, Dept Internal Med, Div Nephrol & Hypertens, Yahaba, Iwate, Japan
[7] Iwate Med Univ, Dept Hyg & Prevent Med, Yahaba, Iwate, Japan
[8] Iwate Med Univ, Disaster Reconstruct Ctr, Iwate Tohoku Med Megabank Org, Yahaba, Iwate, Japan
[9] Iwate Med Univ, Inst Biomed Sci, Dept Neurosci, Yahaba, Iwate, Japan
[10] Iwate Med Univ, Inst Biomed Sci, Div Ultrahigh Field MRI, Yahaba, Iwate, Japan
关键词
chronic kidney disease; high-sensitivity cardiac troponin T; N-terminal pro-brain natriuretic peptide; urine albumin-to-creatinine ratio; Suita score; RENAL-FUNCTION; NATRIURETIC PEPTIDE; CARDIAC TROPONIN; SERUM CREATININE; URIC-ACID; RISK-FACTOR; KIDNEY; DISEASE; ATHEROSCLEROSIS; ASSOCIATION;
D O I
10.2188/jea.JE20180274
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Epidemiological studies have shown that high circulating cystatin C is associated with a risk of cardiovascular disease (CVD) independent of creatinine-based renal function measurements. The present study investigated the comparison between the cystatin C-based estimated glomerular filtration rate (GFRcys) and creatinine-based GFR (GFRcr) to determine whether these measurements are associated with CV biomarkers and elevated CVD risk in a general Japanese population. Methods: The Iwate Tohoku Medical Megabank Organization pooled individual participant data from a general population-based cohort study in Iwate prefecture (n = 29,375). Chronic kidney disease (CKD) was estimated using the GFRcys, GFRcr and the urine albumin-to-creatinine ratio (UACR). Results: The prevalence of CKD in the participants was found to be higher based on the GFRcr than the GFRcys. Multiple variable analyses after adjusting for baseline characteristics showed that high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were associated with the GFRcys. The area under the receiver operating characteristic (AUROC) curve for identifying individuals with a high Suita score was higher for the GFRcys (AUROC = 0.68) than it was for the GFRcr (AUROC = 0.64, P < 0.001). The GFRcys provided reclassification improvement for the CVD risk prediction model by the GFRcr (net reclassification improvement = 0.341; integrated discrimination improvement = 0.018, respectively, P < 0.001). Conclusions: The GFRcys is more closely associated with CV biomarkers, including hs-cTnT and NT-proBNP levels, and a high Suita score than the GFRcr, and it provides additional value in the assessment of CVD risk using GFRcr.
引用
收藏
页码:260 / 267
页数:8
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