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Association between markers of renal function and C-reactive protein level in the elderly: confounding by functional status.
Scand J Clin Lab Invest. 2008; 68(6):484-91.SJ

Abstract

OBJECTIVE

To analyse the cross-sectional association between measures of renal function and inflammation in an elderly population and to evaluate the confounding effect of impaired physical functioning on these relationships.

MATERIAL AND METHODS

Cystatin C and creatinine were measured in serum samples from 1110 elderly subjects in a community-based cross-sectional survey (Lieto Study) in southwestern Finland. Glomerular filtration rate (GFR) was estimated by means of the Modification of Diet in Renal Disease (MDRD) equation. Associations between renal measures and sensitive C-reactive protein (CRP) and the impact of functional status were determined by multivariate linear models.

RESULTS

Based on standardized coefficients, cystatin C (beta 0.19; p<0.001) showed the strongest association with CRP compared to creatinine (beta 0.14; p<0.001) and estimated GFR (beta -0.13; p<0.001). Levels of CRP linearly increased across quintiles of cystatin C, whereas for creatinine and estimated GFR the increase was less graded. Impaired physical functioning was strongly associated with elevated levels of cystatin C (p<0.001) and CRP (p<0.001), but not with creatinine (p = 0.45) or estimated GFR (p = 0.38). For persons with impaired physical functioning, the odds ratio for belonging to the highest compared to the lowest cystatin C quintile was 7.04 (95% confidence interval 3.49-14.9; p<0.001), whereas for creatinine and estimated GFR this difference was not significant.

CONCLUSION

The weaker association observed between CRP and creatinine-based measures, as compared to cystatin C, reflects the misclassification of elderly frail subjects as having normal kidney function rather than suggests cystatin C itself to be a marker of inflammation.

Authors+Show Affiliations

Salo Health Center, Salo, Finland. elise.wasen@utu.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18609082

Citation

Wasén, E, et al. "Association Between Markers of Renal Function and C-reactive Protein Level in the Elderly: Confounding By Functional Status." Scandinavian Journal of Clinical and Laboratory Investigation, vol. 68, no. 6, 2008, pp. 484-91.
Wasén E, Isoaho R, Vahlberg T, et al. Association between markers of renal function and C-reactive protein level in the elderly: confounding by functional status. Scand J Clin Lab Invest. 2008;68(6):484-91.
Wasén, E., Isoaho, R., Vahlberg, T., Kivelä, S. L., & Irjala, K. (2008). Association between markers of renal function and C-reactive protein level in the elderly: confounding by functional status. Scandinavian Journal of Clinical and Laboratory Investigation, 68(6), 484-91. https://doi.org/10.1080/00365510701854983
Wasén E, et al. Association Between Markers of Renal Function and C-reactive Protein Level in the Elderly: Confounding By Functional Status. Scand J Clin Lab Invest. 2008;68(6):484-91. PubMed PMID: 18609082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between markers of renal function and C-reactive protein level in the elderly: confounding by functional status. AU - Wasén,E, AU - Isoaho,R, AU - Vahlberg,T, AU - Kivelä,S-L, AU - Irjala,K, PY - 2008/7/9/pubmed PY - 2009/2/5/medline PY - 2008/7/9/entrez SP - 484 EP - 91 JF - Scandinavian journal of clinical and laboratory investigation JO - Scand J Clin Lab Invest VL - 68 IS - 6 N2 - OBJECTIVE: To analyse the cross-sectional association between measures of renal function and inflammation in an elderly population and to evaluate the confounding effect of impaired physical functioning on these relationships. MATERIAL AND METHODS: Cystatin C and creatinine were measured in serum samples from 1110 elderly subjects in a community-based cross-sectional survey (Lieto Study) in southwestern Finland. Glomerular filtration rate (GFR) was estimated by means of the Modification of Diet in Renal Disease (MDRD) equation. Associations between renal measures and sensitive C-reactive protein (CRP) and the impact of functional status were determined by multivariate linear models. RESULTS: Based on standardized coefficients, cystatin C (beta 0.19; p<0.001) showed the strongest association with CRP compared to creatinine (beta 0.14; p<0.001) and estimated GFR (beta -0.13; p<0.001). Levels of CRP linearly increased across quintiles of cystatin C, whereas for creatinine and estimated GFR the increase was less graded. Impaired physical functioning was strongly associated with elevated levels of cystatin C (p<0.001) and CRP (p<0.001), but not with creatinine (p = 0.45) or estimated GFR (p = 0.38). For persons with impaired physical functioning, the odds ratio for belonging to the highest compared to the lowest cystatin C quintile was 7.04 (95% confidence interval 3.49-14.9; p<0.001), whereas for creatinine and estimated GFR this difference was not significant. CONCLUSION: The weaker association observed between CRP and creatinine-based measures, as compared to cystatin C, reflects the misclassification of elderly frail subjects as having normal kidney function rather than suggests cystatin C itself to be a marker of inflammation. SN - 1502-7686 UR - https://www.unboundmedicine.com/medline/citation/18609082/Association_between_markers_of_renal_function_and_C_reactive_protein_level_in_the_elderly:_confounding_by_functional_status_ L2 - https://www.tandfonline.com/doi/full/10.1080/00365510701854983 DB - PRIME DP - Unbound Medicine ER -