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Serum cystatin C is associated with kidney function but not with cardiovascular risk factors or subclinical atherosclerosis in patients with Systemic Lupus Erythematosus

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Abstract

Cystatin C (CysC) is a protein considered as an excellent marker of renal function, and it has been suggested as an independent predictor of cardiovascular (CV) risk. We evaluated the association of serum CysC with renal function, CV risk factors, inflammation, and subclinical atherosclerosis in Systemic Lupus Erythematosus (SLE) patients. Sixty-one SLE female patients were selected according to estimated glomerular filtration rate (GFR) > 60 ml/min/1.73m2. Renal function parameters, SLE specific factors, CV risk factors, and inflammatory markers were assessed. Subclinical atherosclerosis was assessed by measuring the carotid-femoral pulse wave velocity (PWV) by Doppler velocimetry. Serum CysC concentration was measured using a particle-enhanced immunonephelometric assay that established 0.59–1.01 mg/l as reference values. Patients with high CysC showed significantly altered creatinine, microalbuminuria, and GFR in addition to a significant higher presence of traditional CV risk factors such as arterial hypertension (p < 0.001), metabolic syndrome (p < 0.001), hypertrigliceridemia (p < 0.001), tobacco habit (p < 0.05), and a strong association with arterial stiffness (p = 0.017). Positive correlation between CysC, homocysteine (r = 0.511; p < 0.001) and fibrinogen levels (r = 0.304; p < 0.02) were also observed. A significantly higher SLICC/ACR score was related to high CysC level (p = 0.011), together with higher endothelin-1 and lower TNF serum concentration (p < 0.005). Considering only patients without any renal impairment (microalbumin/creatinine <30 mg/g), no association between CysC level and CV risk factors, arterial stiffness, or SLE-related factors was found. Serum CysC is a good marker of renal function in SLE patients, but it is not independently associated with cardiovascular risk factor or subclinical atherosclerosis.

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Acknowledgements

We acknowledge the technical assistance of Concepcion Lorences and Gloria Peraile and data analysis support from Isabel Millan at Biostatistics Department. This work has been partially supported by the grant PI16/01480. This project belongs to the State Program for Research on the Challenges of Society, within the framework of the State Plan for Scientific and Technical Research and Innovation 2013–2016, financed by the ISCIII and co-financed by the Funds Feder.

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Authors and Affiliations

  1. Systemic Autoimmune Diseases Unit, Internal Medicine, IDIPHIM (Puerta de Hierro University Hospital Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Joaquin Rodrigo 2, 28222 Majadahonda, Madrid, Spain

    Patricia Garcia-Garcia, Raquel Castejon, Pablo Tutor-Ureta, Susana Mellor-Pita & Miguel Yebra-Bango

  2. Servicio de Medicina Interna, IDIPHIM, Hospital Universitario Puerta de Hierro Majadahonda, Joaquin Rodrigo 2, 28222 Majadahonda, Madrid, Spain

    Raquel Castejon

  3. Biochemistry, IDIPHIM (Puerta de Hierro University Hospital Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Joaquin Rodrigo 2, 28222 Majadahonda, Madrid, Spain

    R. A. Silvestre

  4. Neurology Service, IDIPHIM (Puerta de Hierro University Hospital Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Joaquin Rodrigo 2, 28222 Majadahonda, Madrid, Spain

    Carlos Jimenez-Ortiz

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  1. Patricia Garcia-Garcia
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Correspondence to Raquel Castejon.

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Garcia-Garcia, P., Castejon, R., Tutor-Ureta, P. et al. Serum cystatin C is associated with kidney function but not with cardiovascular risk factors or subclinical atherosclerosis in patients with Systemic Lupus Erythematosus. Clin Rheumatol 36, 2709–2717 (2017). https://doi.org/10.1007/s10067-017-3837-9

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  • DOI: https://doi.org/10.1007/s10067-017-3837-9

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