Cathepsin S as an early biomarker for cardiovascular disease in chronic kidney disease patients

Abstract Introduction: A high incidence of cardiovascular disease (CVD) events and premature mortality is observed in patients with chronic kidney disease (CKD). Thus, new biomarkers that may help predict the development of CVD in early stages of CKD are being investigated along with other traditional risk factors. Objective: To investigate cathepsin S as an early biomarker for CVD in patients with CKD. Methods: A total of 64 patients with CKD were included and classified into 2 groups: CKD patients with established CVD and CKD patients with non-established CVD. All patients were submitted to routine investigations including complete blood count, random blood sugar, glycated hemoglobin (HbA1c), serum electrolytes, urea, creatinine, total protein, total albumin, calcium total, phosphorous, uric acid, vitamin D, parathormone, lipid profile, liver function test, measurement of serum cathepsin S (Cat S), and 2D Echo of the heart. Results: The level of serum Cat S was increased in CKD patients with CVD (p <0.05) as well as in later stages of CKD (p <0.05). CVD was also more common in patients in early stage CKD. In early stages CKD, Cat S and CVD were positively correlated. Conclusion: These findings suggest that serum Cat S might be useful as an early biomarker for CVD in CKD patients.

摘要 引言：慢性肾脏病（chronic kidney disease, CKD）患者心血管疾病（cardiovascular disease, CVD）事件发生率及过早死亡率均处于较高水平。因此，除传统危险因素外，目前正探索可辅助早期预测CKD患者CVD发生风险的新型生物标志物。研究目的：探讨组织蛋白酶S（cathepsin S）作为CKD患者CVD早期生物标志物的潜在价值。研究方法：本研究共纳入64例CKD患者，分为两组：合并确诊CVD的CKD患者组与未合并CVD的CKD患者组。所有受试者均接受常规检查，包括全血细胞计数、随机血糖、糖化血红蛋白（glycated hemoglobin, HbA1c）、血清电解质、尿素、肌酐、总蛋白、总白蛋白、总钙、磷、尿酸、维生素D、甲状旁腺激素（parathormone）、血脂谱、肝功能检测、血清组织蛋白酶S（Cat S）水平测定及心脏二维超声心动图（2D Echo）检查。研究结果：合并CVD的CKD患者血清组织蛋白酶S水平显著升高（p<0.05），且CKD晚期患者的血清组织蛋白酶S水平同样升高（p<0.05）。早期CKD患者中CVD的患病率也更高；在早期CKD患者群体中，血清组织蛋白酶S水平与CVD呈正相关。研究结论：上述研究结果表明，血清组织蛋白酶S或可作为CKD患者CVD的早期生物标志物。