肾功能正常人群血清胱抑素C与颈动脉内膜中层厚度的关系  

Association between serum cystatin C and intima-media thickness of common carotid artery in people with normal renal function

作　　者：汪洋[1] 牟建军[1] 刘富强[1] 褚超[1] 王兰[1] 任珂宇[1] 王静[2] 肖红玉[1] 曹禺[1] 郑树慧[1] 

机构地区：[1]西安交通大学医学院第一附属医院心内科,陕西西安710061 [2]西安交通大学医学院第一附属医院检验科,陕西西安710061

出　　处：《中华高血压杂志》2014年第8期754-758,共5页Chinese Journal of Hypertension

摘　　要：目的探讨肾功能正常人群中血清胱抑素C与颈动脉内膜中层厚度(C-IMT)的关系。方法陕西农村人群中选取肾功能正常者172人(男89人,女83人),年龄(49.6±7.5)岁。超声检测C-IMT;按照C-IMT将人群分为C-IMT<0.9mm(n=154)和C-IMT≥0.9mm(n=18)两组。检测血清胱抑素C浓度、空腹血糖、血肌酐、总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C);采用多元线性回归分析血清胱抑素C与C-IMT之间关系。结果C-IMT≥0.9mm的人群血清胱抑素C浓度高于C-IMT<0.9mm受试者[(0.84±0.19)比(0.70±0.14)mg/L,P<0.05]。随着血清胱抑素C浓度的升高,C-IMT呈现增厚趋势(P趋势<0.01)。C-IMT与胱抑素C、年龄、腰围、体质量指数(BMI)、收缩压、舒张压呈正相关(分别r=0.446,0.215,0.240,0.326,0.188,0.190,均P<0.05)。多元线性回归分析显示,校正年龄与性别后,血清胱抑素C、BMI、收缩压是C-IMT的独立影响因素;进一步校正多种混杂因素后,胱抑素C仍是C-IMT独立预测因素(B=0.215,P<0.01),剔除高血压、糖尿病受试者,血清胱抑素C仍与其相关(B=0.204,P<0.05)。结论肾功能正常人群中血清胱抑素C可能是C-IMT有效的预测指标。Objective To investigate the association between serum cystatin C （Cys C） and the intima-media thickness of carotid artery （C-IMT） in people with normal renal function. Methods A total of 172 subjects with normal renal function averagely aged 49.6±7.5, were recruited from the rural population in Shaanxi province, including 89 males and 83 females. According to C-IMT, they were divided into C-IMT d0.9 mm group [n=154} and C-IMT ≥0.9 mm group （n=18）. Their Cys C, fasting glucose, creatinine, total cholesterol, triglyceride and high density lipoprotein cholesterol levels were measured. C-IMT was evaluated by ultrasound image. The relationship between serum Cys C and C-IMT was analyzed by multiple linear regression. Results Cys C level was higher in C-IMT≥0.9 mm group than in C-IMT〈0.9 mm group [（0.84±0.19） vs （0.70±0.14）mg/L, P〈0.05]. IMT showed a thickening trend with the increase of serum Cys C concentration （P〈0.01）. C-IMT was positively correlated with serum Cys C level, age, waist circumference, body mass index（BMI）, systolic blood pressure （SBP）, diastolic blood pressure （DBP） （r=0. 446, 0. 215, 0. 240, 0. 326, 0. 188 and 0. 190 respectively, all P〈0.05 ）. Stepwise multivariate regression analysis showed that, after adjusting for age and sex, the Cys C level, BMI and SBP were independent predicting factors of C-IMT. Furthermore, after adjusting various confounders, Cys C level was still independent predictors of C-IMT （B=0. 215, P〈0.01）. After excluding hypertensive and diabetic subjects, the serum Cys C remained correlative to C-IMT （B=0. 204, P〈0. 05）. Conclusion Cys C could be a more effective predictor of C-IMT in subjects with normal renal function.

关 键 词：血清胱抑素C 颈动脉内膜中层厚度 动脉粥样硬化 肾功能 

分 类 号：R543.4[医药卫生—心血管疾病]