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ABSTRACT: Background
Epidemiological studies show that high circulating cystatin C is associated with risk of cardiovascular disease (CVD), independent of creatinine-based renal function measurements. It is unclear whether this relationship is causal, arises from residual confounding, and/or is a consequence of reverse causation.Objectives
The aim of this study was to use Mendelian randomization to investigate whether cystatin C is causally related to CVD in the general population.Methods
We incorporated participant data from 16 prospective cohorts (n = 76,481) with 37,126 measures of cystatin C and added genetic data from 43 studies (n = 252,216) with 63,292 CVD events. We used the common variant rs911119 in CST3 as an instrumental variable to investigate the causal role of cystatin C in CVD, including coronary heart disease, ischemic stroke, and heart failure.Results
Cystatin C concentrations were associated with CVD risk after adjusting for age, sex, and traditional risk factors (relative risk: 1.82 per doubling of cystatin C; 95% confidence interval [CI]: 1.56 to 2.13; p = 2.12 × 10(-14)). The minor allele of rs911119 was associated with decreased serum cystatin C (6.13% per allele; 95% CI: 5.75 to 6.50; p = 5.95 × 10(-211)), explaining 2.8% of the observed variation in cystatin C. Mendelian randomization analysis did not provide evidence for a causal role of cystatin C, with a causal relative risk for CVD of 1.00 per doubling cystatin C (95% CI: 0.82 to 1.22; p = 0.994), which was statistically different from the observational estimate (p = 1.6 × 10(-5)). A causal effect of cystatin C was not detected for any individual component of CVD.Conclusions
Mendelian randomization analyses did not support a causal role of cystatin C in the etiology of CVD. As such, therapeutics targeted at lowering circulating cystatin C are unlikely to be effective in preventing CVD.
SUBMITTER: van der Laan SW
PROVIDER: S-EPMC5451109 | biostudies-literature | 2016 Aug
REPOSITORIES: biostudies-literature
van der Laan Sander W SW Fall Tove T Soumaré Aicha A Teumer Alexander A Sedaghat Sanaz S Baumert Jens J Zabaneh Delilah D van Setten Jessica J Isgum Ivana I Galesloot Tessel E TE Arpegård Johannes J Amouyel Philippe P Trompet Stella S Waldenberger Melanie M Dörr Marcus M Magnusson Patrik K PK Giedraitis Vilmantas V Larsson Anders A Morris Andrew P AP Felix Janine F JF Morrison Alanna C AC Franceschini Nora N Bis Joshua C JC Kavousi Maryam M O'Donnell Christopher C Drenos Fotios F Tragante Vinicius V Munroe Patricia B PB Malik Rainer R Dichgans Martin M Worrall Bradford B BB Erdmann Jeanette J Nelson Christopher P CP Samani Nilesh J NJ Schunkert Heribert H Marchini Jonathan J Patel Riyaz S RS Hingorani Aroon D AD Lind Lars L Pedersen Nancy L NL de Graaf Jacqueline J Kiemeney Lambertus A L M LA Baumeister Sebastian E SE Franco Oscar H OH Hofman Albert A Uitterlinden André G AG Koenig Wolfgang W Meisinger Christa C Peters Annette A Thorand Barbara B Jukema J Wouter JW Eriksen Bjørn Odvar BO Toft Ingrid I Wilsgaard Tom T Onland-Moret N Charlotte NC van der Schouw Yvonne T YT Debette Stéphanie S Kumari Meena M Svensson Per P van der Harst Pim P Kivimaki Mika M Keating Brendan J BJ Sattar Naveed N Dehghan Abbas A Reiner Alex P AP Ingelsson Erik E den Ruijter Hester M HM de Bakker Paul I W PI Pasterkamp Gerard G Ärnlöv Johan J Holmes Michael V MV Asselbergs Folkert W FW
Journal of the American College of Cardiology 20160801 9
<h4>Background</h4>Epidemiological studies show that high circulating cystatin C is associated with risk of cardiovascular disease (CVD), independent of creatinine-based renal function measurements. It is unclear whether this relationship is causal, arises from residual confounding, and/or is a consequence of reverse causation.<h4>Objectives</h4>The aim of this study was to use Mendelian randomization to investigate whether cystatin C is causally related to CVD in the general population.<h4>Meth ...[more]