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Relationship between Cystatin C, Retinol-binding Protein 4 and Framingham Risk Score in Healthy Postmenopausal Women
Aleksandra Klisic1, Jelena Kotur-Stevuljevic2, Nebojsa Kavaric1
1Primary Health Care Center, Podgorica, Montenegro.
Insights
High levels of cystatin C and retinol-binding protein 4 (RBP4) are linked to increased cardiovascular risk in postmenopausal women. These proteins, along with BMI and triglycerides, can predict cardiovascular risk effectively.
Area of Science:
- Biochemistry
- Cardiology
- Endocrinology
Background:
- Investigating novel biomarkers for cardiovascular disease (CVD) risk is crucial, especially in postmenopausal women.
- Cystatin C and retinol-binding protein 4 (RBP4) are emerging markers with potential implications for CVD.
- The Framingham Risk Score (FRS) is a traditional tool for assessing cardiovascular risk.
Purpose of the Study:
- To examine the association between elevated cystatin C, RBP4 levels, and cardiovascular risk score (FRS) in postmenopausal women.
- To identify independent predictors of cardiovascular risk in this population.
Main Methods:
- A cohort of 129 healthy postmenopausal women was studied.
- Serum levels of cystatin C, RBP4, glucose, lipids, creatinine, uric acid, and hsCRP were measured.
- Multiple linear regression and Receiver Operating Characteristic (ROC) curve analyses were employed to assess FRS and its predictors.
Main Results:
- Significantly higher cystatin C and RBP4 levels were observed in women with higher FRS (≥10%).
- Multiple linear regression identified body mass index (BMI), triglycerides (TG), RBP4, and cystatin C as significant independent predictors of FRS (R2-adjusted = 0.347).
- A combined model using these four parameters demonstrated excellent discriminatory capability for cardiovascular risk (AUC = 0.820).
Conclusions:
- Elevated cystatin C and RBP4 levels are associated with increased cardiovascular risk in postmenopausal women.
- These proteins may serve as valuable additions to traditional cardiovascular risk assessment tools.
- The findings highlight the potential of cystatin C and RBP4 in predicting cardiovascular risk burden.
Background:
We aimed to examine the relationship between high levels of cystatin C, retinol-binding protein 4 (RBP4) and cardiovascular risk score [determined by Framingham Risk Score (FRS)] in postmenopausal women.
Methods:
A total of apparently healthy 129 postmenopausal women (mean age 57.1 ± 4.6 years) were included. Serum cystatin C, RBP4, glucose, lipid parameters, creatinine, uric acid and high sensitivity C-reactive protein (hsCRP) were determined. Anthropometric parameters and blood pressure were also obtained. FRS was calculated. Multiple linear regression analysis (MLR) was performed to identify independent factors affecting FRS and to estimate the final predictors of its variability. Receiver Operating Characteristic (ROC) curve analysis was used with the purpose of testing discriminatory potential of a group of parameters selected in MLR analysis, with FRS level as dependent variable.
Results:
We found significantly higher levels of both proteins, cystatin C (P = 0.001) and RBP4 (P = 0.006), in the FRS higher (medium and high) risk groups (FRS ≥ 10%) compared to low risk FRS group (FRS < 10%). MLR revealed the best model consisting of 4 parameters (e.g., body mass index (BMI) (P < 0.001), triglycerides (TG) (P = 0.004), RBP4 (P = 0.021), and cystatin C (P = 0.046), R2-adjusted = 0.347) for FRS prediction. Construction of a model consisted of those 4 FRS formula independent parameters (BMI, TG, cystatin C and RBP4) using logistic regression analysis showed that new ROC curve had excellent discriminatory capability (area under the curve = 0.820).
Conclusion:
High cystatin C and retinol-binding protein 4 may contribute significantly to cardiovascular risk burden in addition to traditional cardiovascular markers.
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