Independent associations of urinary albumin-to-creatinine ratio and serum cystatin C with carotid intima-media thickness
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RESEARCH ARTICLE
Open Access
Independent associations of urinary albumin-to-creatinine ratio and serum cystatin C with carotid intima-media thickness in community-living Taiwanese adults Chiu-Shong Liu1,2, Chia-Ing Li1,3, Yuh-Cherng Guo4, Chih-Hsueh Lin1,2, Wen-Yuan Lin1,2, Chung-Hsiang Liu4, Mu-Cyun Wang1,2, Chuan-Wei Yang3, Shing-Yu Yang5, Tsai-Chung Li5,6* and Cheng-Chieh Lin1,2,3
Abstract Background: Renal function is a key factor of cardiovascular disease. Carotid intima-media thickness (IMT) has been widely used as a marker of early subclinical atherosclerosis. The determinants of cystatin C, a novel marker of renal function, have not been extensively studied in the Asian population. This study aimed to assess the determinants of cystatin C and explore whether carotid thickening was associated with urinary albumin-creatinine ratio and cystatin C in community-living Taiwanese adults. Methods: A cross-sectional study was conducted on participants from Taichung City, Taiwan. All the participants underwent carotid ultrasonography. Carotid IMT-mean and IMT-maximum were derived. Kidney biomarkers were measured on the basis of urinary albumin-to-creatinine ratio (ACR) and cystatin C. Multiple linear regression analysis was used. Results: A total of 1032 individuals were recruited, and 469 (45.44%) of them were men. An increased cystatin C level was significantly associated with older age, male gender, lack of physical activity, low HDL cholesterol, abdominal obesity, high hs-CRP, and high ACR. The multivariate-adjusted mean carotid IMT-mean and IMT-maximum values significantly increased by 80.49 and 195.23 μm for every one unit of increase in cystatin C level and by 0.07 and 0.14 μm for every one unit of increase in ACR, respectively (all p < 0.001 except ACR on IMT-maximum with p < 0.01). Lack of physical activity, low HDL, abdominal obesity, high hs-CRP, and high ACR were the determinants of cystatin C. Conclusion: Cystatin C and ACR were strongly and linearly associated with carotid thickening, a marker of subclinical atherosclerosis. Keywords: Intima-media thickness, Cystatin C, Creatinine, Albumin-to-creatinine ratio
* Correspondence: [email protected] 5 Department of Public Health, College of Public Health, China Medical University, 91 Hsueh-Shih Road, Taichung 40421, Taiwan 6 Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material.
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