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Plasma cathepsin S and cystatin C levels and risk of abdominal aortic aneurysm: a randomized population-based study
Bing-Jie Lv1, Jes S Lindholt, Xiang Cheng
1Institute of Cardiology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
Insights
Plasma cathepsin S (CatS) is elevated in abdominal aortic aneurysm (AAA) patients, while cystatin C is decreased. These findings suggest CatS and cystatin C as potential biomarkers for AAA and peripheral arterial disease.
Area of Science:
- Biochemistry
- Vascular Biology
- Biomarkers
Background:
- Abdominal aortic aneurysm (AAA) lesions show high cathepsin S (CatS) and low cystatin C.
- Plasma levels of CatS and cystatin C in AAA patients are not well understood.
Purpose of the Study:
- To investigate plasma levels of CatS and cystatin C in patients with AAA.
- To determine the association of these proteins with AAA risk and disease severity.
Main Methods:
- Plasma samples from 476 male AAA patients and 200 controls were analyzed using ELISA.
- Statistical analyses included Student's t test, ROC curve analysis, logistic regression, and correlation analyses.
Main Results:
- AAA patients exhibited significantly higher plasma levels of total, active, and pro-CatS compared to controls.
- Plasma cystatin C levels were significantly lower in AAA patients.
- Elevated CatS and decreased cystatin C were independent risk factors for AAA and correlated with aortic diameter and ankle-brachial index (ABI).
Conclusions:
- Plasma CatS and cystatin C levels are altered in AAA patients.
- These proteins may serve as valuable serological biomarkers for peripheral arterial diseases, including AAA.
Background:
Human abdominal aortic aneurysm (AAA) lesions contain high levels of cathepsin S (CatS), but are deficient in its inhibitor, cystatin C. Whether plasma CatS and cystatin C levels are also altered in AAA patients remains unknown.
Methods And Results:
Plasma samples were collected from 476 male AAA patients and 200 age-matched male controls to determine CatS and cystatin C levels by ELISA. Student's t test demonstrated higher plasma levels of total, active, and pro-CatS in AAA patients than in controls (P<0.001). ROC curve analysis confirmed higher plasma total, active, and pro-CatS levels in AAA patients than in controls (P<0.001). Logistic regression suggested that plasma total (odds ratio [OR] = 1.332), active (OR = 1.21), and pro-CatS (OR = 1.25) levels were independent AAA risk factors that associated positively with AAA (P<0.001). Plasma cystatin C levels associated significantly, but negatively, with AAA (OR = 0.356, P<0.001). Univariate correlation demonstrated that plasma total and active CatS levels correlated positively with body-mass index, diastolic blood pressure, and aortic diameter, but negatively with the lowest ankle-brachial index (ABI). Plasma cystatin C levels also correlated negatively with the lowest ABI. Multivariate linear regression showed that plasma total, active, and pro-CatS levels correlated positively with aortic diameter and negatively with the lowest ABI, whereas plasma cystatin C levels correlated negatively with aortic diameter and the lowest ABI, after adjusting for common AAA risk factors.
Conclusions:
Correlation of plasma CatS and cystatin C with aortic diameter and the lowest ABI suggest these serological parameters as biomarkers for human peripheral arterial diseases and AAA.
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