TY - JOUR
T1 - Association of albumin-creatinine ratio and cystatin C with change in ankle-brachial index
T2 - The multi-ethnic study of atherosclerosis (MESA)
AU - Garimella, Pranav S.
AU - Ix, Joachim H.
AU - Katz, Ronit
AU - Shlipak, Michael G.
AU - Criqui, Michael H.
AU - Siscovick, David S.
AU - Kramer, Holly
AU - Sibley, Christopher T.
AU - Sarnak, Mark J.
PY - 2014
Y1 - 2014
N2 - Background: Low ankle-brachial index (ABI) is a reflection of atherosclerotic disease, and high ABI is an indicator of calcified vessels. The associations of albuminuria and cystatin C level with incidence of either low or high ABI are unknown. Study Design: Prospective longitudinal cohort study. Setting & Participants: MESA (Multi-Ethnic Study of Atherosclerosis) enrolled community-dwelling adults (N = 6,814) aged 45-84 years who were free of clinical cardiovascular disease at baseline. Predictors: Baseline albumin-creatinine ratio (ACR) and serum cystatin C level. Outcomes: Development of low (1.40) ABI using multinomial regression among persons with ABI of 0.90-1.40 at baseline. Results: During 9.8 years of follow-up, 221 and 89 participants progressed to low and high ABIs, respectively. Baseline ACR and cystatin C level were higher among progressors compared with nonprogressors. In multivariable analyses, doubling of ACR was associated with increased risk of progression to low (OR, 1.08; 95% CI, 0.99-1.20) and high (OR, 1.16; 95% CI, 1.01-1.32) ABIs. Compared to the lowest quintile, the highest quintile of ACR had a significantly increased risk of progression to low (OR, 1.79; 95% CI, 1.03-3.12) and high (OR, 2.76; 95% CI, 1.32-5.77) ABIs. Higher cystatin C levels were associated with progression to low (OR per 1-SD greater, 1.12; 95% CI, 1.00-1.26) but not high (OR per 1-SD greater, 1.01; 95% CI, 0.81-1.25) ABI, but the highest quintile of cystatin C was not associated independently with either outcome. Limitations: Single measure of albuminuria and low number of progressors to high ABI. Conclusions: In adults free of clinical cardiovascular disease, albuminuria was a strong independent risk factor for the development of both high and low ABIs, important and different measures of peripheral artery disease.
AB - Background: Low ankle-brachial index (ABI) is a reflection of atherosclerotic disease, and high ABI is an indicator of calcified vessels. The associations of albuminuria and cystatin C level with incidence of either low or high ABI are unknown. Study Design: Prospective longitudinal cohort study. Setting & Participants: MESA (Multi-Ethnic Study of Atherosclerosis) enrolled community-dwelling adults (N = 6,814) aged 45-84 years who were free of clinical cardiovascular disease at baseline. Predictors: Baseline albumin-creatinine ratio (ACR) and serum cystatin C level. Outcomes: Development of low (1.40) ABI using multinomial regression among persons with ABI of 0.90-1.40 at baseline. Results: During 9.8 years of follow-up, 221 and 89 participants progressed to low and high ABIs, respectively. Baseline ACR and cystatin C level were higher among progressors compared with nonprogressors. In multivariable analyses, doubling of ACR was associated with increased risk of progression to low (OR, 1.08; 95% CI, 0.99-1.20) and high (OR, 1.16; 95% CI, 1.01-1.32) ABIs. Compared to the lowest quintile, the highest quintile of ACR had a significantly increased risk of progression to low (OR, 1.79; 95% CI, 1.03-3.12) and high (OR, 2.76; 95% CI, 1.32-5.77) ABIs. Higher cystatin C levels were associated with progression to low (OR per 1-SD greater, 1.12; 95% CI, 1.00-1.26) but not high (OR per 1-SD greater, 1.01; 95% CI, 0.81-1.25) ABI, but the highest quintile of cystatin C was not associated independently with either outcome. Limitations: Single measure of albuminuria and low number of progressors to high ABI. Conclusions: In adults free of clinical cardiovascular disease, albuminuria was a strong independent risk factor for the development of both high and low ABIs, important and different measures of peripheral artery disease.
KW - Albumin-creatinine ratio (ACR)
KW - Albuminuria
KW - Ankle-brachial index (ABI)
KW - Atherosclerotic disease
KW - Cardiovascular disease (CVD)
KW - Chronic kidney disease (CKD)
KW - Cystatin C
KW - Peripheral artery disease (PAD)
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UR - http://www.scopus.com/inward/citedby.url?scp=84922418023&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2014.05.014
DO - 10.1053/j.ajkd.2014.05.014
M3 - Article
C2 - 24998036
AN - SCOPUS:84922418023
SN - 0272-6386
VL - 65
SP - 33
EP - 40
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 1
ER -