High levels of cystatin C predict the metabolic syndrome: the prospective Malmö Diet and Cancer Study.

• OBJECTIVE: 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. METHODS: 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: MetS and long-term progression as well as incidence of the different components of the MetS. RESULTS: During follow-up, 428 subjects developed new-onset MetS. In age- and sex-adjusted analysis, compared to 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, (P(trend) <0.001); this linear association remained significant even after full multivariate adjustment (P(trend) =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 (P(trend) =0.008). CONCLUSION: 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. © 2013 The Association for the Publication of the Journal of Internal Medicine.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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