体检人群代谢综合征与血清胱抑素 C 水平的相关性

目的：探讨体检人群代谢综合征(metabolic syndrome，MetS)与血清胱抑素C(cystatin C，Cys-C)水平的相关 性。方法：以中南大学湘雅三医院健康管理中心6 783例体检人群为研究对象进行横断面研究。将人群分为3组，其 中MetS组1 578例，代谢异常(metabolic disturbance，MetD)组3 617例，健康对照(healthy control，HC)组1 588名。收集一 般资料、进行体格检查及生化指标检测。比较各组间一般临床资料的特点；采用多因素logistic回归分析Cys-C对MetS 的影响，协方差分析代谢异常组分数与Cys-C水平的关系。结果：与HC组比较，MetS组和MetD组Cys-C水平明显增 高；且MetS组明显高于MetD组(P<0.05)。校正年龄、性别、血压、吸烟、饮酒、绝经状态、腰围、体质量指数、血 糖、血脂、估算肾小球滤过率、血尿酸、尿微量白蛋白、超敏C反应蛋白、同型半胱氨酸因素后，Cys-C高水平是 MetS的独立危险因素(OR=1.951，95% CI 1.265~3.009，P<0.05)。随着Cys-C水平四分位数增高，其患MetS的优势比增加 (P<0.05)。随着代谢异常组分数增加，血清Cys-C水平显著增高(P<0.01)。结论：体检人群中Cys-C与MetS有明显相关 性，且Cys-C水平可能与MetS代谢异常的严重性有关。

Association of metabolic syndrome with serum cystatin C in people undergoing health examination

Objective: To investigate the relationship between metabolic syndrome (MetS) and cystatin C in people undergoing healthy examination. Methods: A total of 6 783 subjects were analyzed. Th ey were divided into MetS group (n=1 578), metabolic disturbance (MetD) group (n=3 617) and healthy control (HC) group (n=1 588). Th e general information, anthropometry, blood sample and urine sample were collected for all the subjects. Multiple logistic regression analysis was used to identify risk factors for MetS and analysisof covariance was used to investigate the correlation between the number of metabolic disturbance components and cystatin C. Results: Compared with the HC group, the level of cystatin C significantly increased in MetS and MetD group; compared with MetD group, the level of cystatin C significantly increased in MetS group (P<0.05). After correction by age, sex, smoking, alcohol intake, menopause, waist circumference, body mass index, blood pressure, plasma cholesterol, fasting plasma glucose, estimated glomerular filtration rate, serum uric acid, microalbuminria, high sensitive C-reaction protein and homocysteine, the cystatin C was closely related with MetS (OR=1.951, 95% CI 1.265– 3.009, P<0.05). Similarly, the OR value of risk with MetS was increased with the quartile of cystatin C level (P<0.05). In addition, with the increase in metabolic disturbance components, the level of cystatin C was also increased significantly (P<0.01). Conclusion: Serum cystatin C in our study was significantly associated with MetS. Moreover, the level of cystatin C may be correlated with severity of MetD.