eGFRCystatin C, difference between eGFRCystatin C and eGFRCre and heart failure: Insight from the NHANES 2001–2002 and Mendelian randomization analysis

Aim: Estimated glomerular filtration rate (eGFR) derived from Cystatin C (eGFRCystatin C), and the difference between Cystatin C and creatinine based eGFR (eGFRdiff) has been suggested to be associated with cardiovascular disease. However, the association between eGFRCystatin C,eGFRdiff and heart fa...

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Main Authors: Zhiyu Gu, Rui Zhang, Weihong Chang, Hongxuan Fan, Zixuan Dou, Peng Liu, Aman Liu, Boda Zhou
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:International Journal of Cardiology. Cardiovascular Risk and Prevention
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772487524001028
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author Zhiyu Gu
Rui Zhang
Weihong Chang
Hongxuan Fan
Zixuan Dou
Peng Liu
Aman Liu
Boda Zhou
author_facet Zhiyu Gu
Rui Zhang
Weihong Chang
Hongxuan Fan
Zixuan Dou
Peng Liu
Aman Liu
Boda Zhou
author_sort Zhiyu Gu
collection DOAJ
description Aim: Estimated glomerular filtration rate (eGFR) derived from Cystatin C (eGFRCystatin C), and the difference between Cystatin C and creatinine based eGFR (eGFRdiff) has been suggested to be associated with cardiovascular disease. However, the association between eGFRCystatin C,eGFRdiff and heart failure (HF) risk has not been elucidated in a relatively healthy cohort. Methods: We used cohort study data from the NHANES 2001–2002. Mendelian randomization (MR) study used GWAS data from 437,846 European participants. The exposures are eGFRCystatin C &amp; eGFRdiff, outcome is self reported heart failure. Weighted multivariable-adjusted logistic regression and Kaplan-Meier survival analysis was used in corhort study. Inverse variance weighted (IVW) was applied in MR study. Results: The cohort study included 2155 participants. Importantly, we simplified eGFRdiff classification into ≥0 and < 0, and found that eGFRdiff≥0 was associated with 52 % reduction of HF risk (OR 0.48, [95 % CI, 0.29–0.80], p = 0.005). We also found that 1 ml/min/1.73 m2 of eGFRCystatin C had a significant negative association with HF after adjusting for covariates. Interestingly, we showed a non-linear association between eGFRCystatin C and HF, eGFRdiff and HF. In participants without know HF, during a median follow-up of 17.3 years, those in the low eGFRCystatin C or low eGFRdiff groups showed significantly poorer survival. Moreover, MR analysis found genetic predisposition to cystatin C was significantly associated with an increased risk of HF. Conclusion: Both decreased eGFRCystatin C and eGFRdiff levels were associated with heart failure and poor survival, but the latter seems more obvious.
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spelling doaj-art-9afd6a0718894c0fb3691b21e5231f3d2025-08-20T01:54:15ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752024-12-012320033710.1016/j.ijcrp.2024.200337eGFRCystatin C, difference between eGFRCystatin C and eGFRCre and heart failure: Insight from the NHANES 2001–2002 and Mendelian randomization analysisZhiyu Gu0Rui Zhang1Weihong Chang2Hongxuan Fan3Zixuan Dou4Peng Liu5Aman Liu6Boda Zhou7Institute for Immunology, School of Medicine, Tsinghua University, Beijing, 100084, ChinaDepartment of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China; School of Clinical Medicine, Tsinghua University, Beijing, 102218, ChinaDepartment of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China; School of Clinical Medicine, Tsinghua University, Beijing, 102218, ChinaDepartment of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China; School of Clinical Medicine, Tsinghua University, Beijing, 102218, ChinaSchool of Medicine, Tsinghua University, Beijing, 10084, ChinaDepartment of Cardiology, Ordos Central Hospital, Ordos School of Clinical Medicine, Inner Mongolia Medical University, 23 Yijinhuoluo West Street, Dongsheng District, Inner Mongolia, 017000, ChinaDepartment of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China; School of Clinical Medicine, Tsinghua University, Beijing, 102218, ChinaDepartment of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China; Corresponding author. Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 168 Litang Road, Changping District, Beijing, 102218, China.Aim: Estimated glomerular filtration rate (eGFR) derived from Cystatin C (eGFRCystatin C), and the difference between Cystatin C and creatinine based eGFR (eGFRdiff) has been suggested to be associated with cardiovascular disease. However, the association between eGFRCystatin C,eGFRdiff and heart failure (HF) risk has not been elucidated in a relatively healthy cohort. Methods: We used cohort study data from the NHANES 2001–2002. Mendelian randomization (MR) study used GWAS data from 437,846 European participants. The exposures are eGFRCystatin C &amp; eGFRdiff, outcome is self reported heart failure. Weighted multivariable-adjusted logistic regression and Kaplan-Meier survival analysis was used in corhort study. Inverse variance weighted (IVW) was applied in MR study. Results: The cohort study included 2155 participants. Importantly, we simplified eGFRdiff classification into ≥0 and < 0, and found that eGFRdiff≥0 was associated with 52 % reduction of HF risk (OR 0.48, [95 % CI, 0.29–0.80], p = 0.005). We also found that 1 ml/min/1.73 m2 of eGFRCystatin C had a significant negative association with HF after adjusting for covariates. Interestingly, we showed a non-linear association between eGFRCystatin C and HF, eGFRdiff and HF. In participants without know HF, during a median follow-up of 17.3 years, those in the low eGFRCystatin C or low eGFRdiff groups showed significantly poorer survival. Moreover, MR analysis found genetic predisposition to cystatin C was significantly associated with an increased risk of HF. Conclusion: Both decreased eGFRCystatin C and eGFRdiff levels were associated with heart failure and poor survival, but the latter seems more obvious.http://www.sciencedirect.com/science/article/pii/S2772487524001028Heart failureCystatin CeGFRNational health and nutrition examination surveyMendelian randomization
spellingShingle Zhiyu Gu
Rui Zhang
Weihong Chang
Hongxuan Fan
Zixuan Dou
Peng Liu
Aman Liu
Boda Zhou
eGFRCystatin C, difference between eGFRCystatin C and eGFRCre and heart failure: Insight from the NHANES 2001–2002 and Mendelian randomization analysis
International Journal of Cardiology. Cardiovascular Risk and Prevention
Heart failure
Cystatin C
eGFR
National health and nutrition examination survey
Mendelian randomization
title eGFRCystatin C, difference between eGFRCystatin C and eGFRCre and heart failure: Insight from the NHANES 2001–2002 and Mendelian randomization analysis
title_full eGFRCystatin C, difference between eGFRCystatin C and eGFRCre and heart failure: Insight from the NHANES 2001–2002 and Mendelian randomization analysis
title_fullStr eGFRCystatin C, difference between eGFRCystatin C and eGFRCre and heart failure: Insight from the NHANES 2001–2002 and Mendelian randomization analysis
title_full_unstemmed eGFRCystatin C, difference between eGFRCystatin C and eGFRCre and heart failure: Insight from the NHANES 2001–2002 and Mendelian randomization analysis
title_short eGFRCystatin C, difference between eGFRCystatin C and eGFRCre and heart failure: Insight from the NHANES 2001–2002 and Mendelian randomization analysis
title_sort egfrcystatin c difference between egfrcystatin c and egfrcre and heart failure insight from the nhanes 2001 2002 and mendelian randomization analysis
topic Heart failure
Cystatin C
eGFR
National health and nutrition examination survey
Mendelian randomization
url http://www.sciencedirect.com/science/article/pii/S2772487524001028
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