Cystatin C and sarcopenia index are associated with all-cause and cardiovascular death among adults in the United States

Abstract

Abstract Objectives This study aimed to investigate the potential association between cystatin C, creatinine, and the sarcopenia index (SI) and cardiovascular and all-cause death in general population. Methods Data of participants from the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2004 were used and all participants were followed up regularly until December 31, 2019. Multivariable Cox analysis was used to investigate the potential association between the potential risk factors and cardiovascular and all-cause death. Restricted cubic spline regression was conducted to evaluate the potential nonlinearity between potential risk factors and death. Results In this study, 9894 participants with a mean age of 45.64 years were enrolled and followed up for a mean duration of 15.62 ± 4.68 years. About 50.3% were men and a total of 2681 all-cause deaths and 691 cardiovascular deaths were recorded. In multivariable Cox models, higher cystatin C level (≥ 0.877 vs. <0.659) was associated with an increased risk of cardiovascular death (HR:3.36, 95% CI: 2.06–5.46, p < 0.001) and all-cause death (HR:2.71, 95% CI: 2.17–3.38, p < 0.001). However, lower SI (< 88.41 vs. ≥125.52) was associated with a higher risk of cardiovascular death (HR:2.56, 95% CI: 1.88–3.49, p < 0.001) and all-cause death (HR:2.45, 95% CI: 2.07–2.90, p < 0.001). Additionally, a J-shaped curve association was found between cardiovascular and all-cause death and creatinine. Conclusions Cystatin C and SI are associated with cardiovascular and all-cause death in general population in the United States. There is a J-shaped curve association between creatinine and cardiovascular and all-cause death among US adults.