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
| Autor: | Mamoru Satoh, Kozo Tanno, Kiyomi Sakata, Yoshihiro Morino, Kenji Sobue, Yuji Takahashi, Takuya Osaki, Makoto Sasaki, Fumitaka Tanaka, Takahito Nasu |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Epidemiology Population Renal function Risk Assessment Cohort Studies chemistry.chemical_compound Japan Internal medicine Cardiovascular Disease high-sensitivity cardiac troponin T medicine Humans Cystatin C Renal Insufficiency Chronic education Aged lcsh:R5-920 Creatinine education.field_of_study Receiver operating characteristic biology business.industry urine albumin-to-creatinine ratio General Medicine Middle Aged medicine.disease N-terminal pro-brain natriuretic peptide chemistry Cardiovascular Diseases Cardiology biology.protein Female Original Article lcsh:Medicine (General) business Suita score Biomarkers chronic kidney disease Kidney disease Cohort study Glomerular Filtration Rate |
| Zdroj: | Journal of Epidemiology Journal of Epidemiology, Vol 30, Iss 6, Pp 260-267 (2020) |
| ISSN: | 1349-9092 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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