Clinical correlates and heritability of cystatin C (from the Framingham Offspring Study)

Nisha I Parikh1, Shih-Jen Hwang, Qiong Yang

  • 1National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA.

Insights

High levels of Cystatin C (CysC) correlate with cardiovascular disease (CVD) risk factors, even without chronic kidney disease (CKD). These associations may explain CysC

Area of Science:

  • Clinical Biochemistry
  • Cardiovascular Medicine
  • Nephrology

Background:

  • Cystatin C (CysC) is recognized as a biomarker linked to cardiovascular disease (CVD) and chronic kidney disease (CKD).
  • Understanding the clinical correlates and genetic basis of CysC is crucial for its interpretation in disease risk assessment.

Purpose of the Study:

  • To investigate the clinical factors associated with elevated Cystatin C (CysC) levels.
  • To determine the heritability of CysC.
  • To examine whether the relationship between CVD risk factors and CysC is modified by the presence of CKD.

Main Methods:

  • Analysis of data from the Framingham Heart Study offspring cohort (n=3,241).
  • Development of a 95th percentile cut-point for high CysC in a healthy subset, excluding participants with prevalent CVD, CKD, and other risk factors.
  • Multivariable logistic regression to assess associations between CVD risk factors and high CysC; variance-components method for heritability estimation in a family-based subset (n=1,188).

Main Results:

  • A cut-point for high CysC was established at 1.07 mg/L.
  • Age, hypertension treatment, low diastolic blood pressure, body mass index, low high-density lipoprotein cholesterol, and smoking were significantly associated with high CysC.
  • These factors, along with estimated glomerular filtration rate (eGFR), explained 39.2% of CysC variability. Heritability of CysC was estimated at 0.35 (p <0.001). Associations remained consistent when CKD was excluded.

Conclusions:

  • Elevated Cystatin C (CysC) is associated with multiple cardiovascular disease (CVD) risk factors, independent of chronic kidney disease (CKD) status.
  • The strong link between CysC and CVD risk factors provides a potential explanation for CysC's predictive power in incident CVD.

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