Serum cystatin C and emphysema: results from the National Health and Nutrition Examination Survey (NHANES).
Lung
; 190(3): 283-90, 2012 Jun.
Article
en En
| MEDLINE
| ID: mdl-22286538
ABSTRACT
BACKGROUND:
Cystatin C (CysC) is a potent nonorgan-specific cysteine protease inhibitor and may contribute to elastolysis and tissue destruction by a mechanism of proteaseantiprotease imbalance. Given the prevalence of CysC in the serum of smokers and its role in tissue destruction, we aimed to evaluate the association between CysC and emphysema.METHODS:
Pooled cross-sectional data from the National Health and Nutrition Examination Survey 19992002 were used. Emphysema and chronic bronchitis were defined by a self-reported history ascertained using standardized questionnaires. Active smokers were defined as self-reported current smokers or measured serum cotinine ≥10 ng/mL. Nonactive smokers with a serum cotinine level >0.05 ng/mL were defined as environmental tobacco smoke (ETS)-exposed.RESULTS:
The prevalence (95% CI) of emphysema was 1.3% (range = 0.91.8%). The mean (SE) CysC level in the emphysema group was significantly higher than in normal controls [1,139 (22) vs. 883 (8) µg/L; p = 0.001]. Upon stratification of the study population by C-reactive protein (CRP) concentrations, we demonstrated a progressive increase in the mean serum CysC level with serially increasing CRP concentrations. Active smokers with emphysema had 115.4 (46.5) µg/L higher mean (SE) CysC levels than the normal controls (p < 0.001). Upon adjusted analysis, we observed that nonactive smokers with significant ETS exposure had 31.2 (15.2) µg/L higher mean (SE) serum CysC levels as compared to ETS unexposed nonactive smokers (p = 0.04).CONCLUSION:
In a large representative noninstitutionalized US population, we demonstrated an association between emphysema and serum CysC. Active smokers with emphysema had significantly higher CysC levels. These findings suggest that CysC may play a role in the pathogenesis of smoking-related emphysema.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfisema
/
Cistatina C
Tipo de estudio:
Etiology_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Lung
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos