Severe obstructive sleep apnea increases cystatin C in clinically latent renal dysfunction

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• 作者：Kota Kato^a ; Yoshifumi Takata ; ^a ; ^{takatamd@gb3.so-net.ne.jp} ; Yasuhiro Usui^a ; Kazuki Shiina^a ; Kihiro Asano^a ; Yuki Hashimura^a ; Hirokazu Saruhara^a ; Yosuke Nishihata^a ; Hirofumi Tomiyama^a ; Akira Yamashina^a
• 关键词：Obstructive sleep apnea ; Cystatin C ; Renal function ; Cardiovascular risk ; Clinically latent chronic kidney disease
• 刊名：Respiratory Medicine
• 出版年：2011
• 出版时间：April 2011
• 年：2011
• 卷：105
• 期：4
• 页码：643-649
• 全文大小：343 K

文摘

Summary

Background

Obstructive sleep apnea (OSA) increases the risk of cardiovascular disease (CVD) and has been reported to be associated with chronic kidney disease (CKD). Recent studies have demonstrated that cystatin C is a prognostic biomarker of the risk of death and CVD even in patients without established CKD.

Methods

In a cross-sectional study, we enrolled 267 consecutive OSA patients without CKD who had an apnea-hypopnea index (AHI) ≥ 5 events per hour in overnight polysomnography. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² according to the modification of diet in renal disease (MDRD) equation (modified for Japanese). Serum cystatin C levels were measured in all patients.

Results

Cystatin C was significantly correlated with age (r = 0.37), body mass index (BMI) (r = 0.12), AHI (r = 0.17), C-reactive protein (CRP) (r = 0.12), and Brachial-ankle pulse wave velocity (r = 0.18). Logistic regression analysis demonstrated that severe OSA defined by an AHI ≥ 30 events per hour was an independent variable for the highest quartiles of serum cystatin C levels (≥0.88 mg/L) (OR: 2.04, 95 % CI: 1.04–4.01, P = 0.04) even after adjustment for age, BMI ≥ 25, hypertension, and diabetes mellitus.

Conclusions

This study indicates that severe OSA independently increases serum cystatin C levels in patients without CKD. Cystatin C is considered to be a biomarker that reflects both clinically latent renal dysfunction and cardiovascular risk that are influenced by OSA.