{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T22:58:20Z","timestamp":1784761100860,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,7]],"date-time":"2019-01-07T00:00:00Z","timestamp":1546819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Cathepsin S is highly expressed in subcutaneous and visceral adipose tissue. Cathepsin S correlates with central obesity and contributes to the formation and progression of atherosclerosis. Here, we sought to evaluate the association of serum cathepsin S with metabolic syndrome (MS) in overweight and obese Chinese adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated serum cathepsin S levels in a cross\u2010sectional sample of 781 overweight and obese Chinese adults by ELISA. Glucose, insulin, lipid profile, inflammatory markers, and adipokines were also measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cathepsin S was significantly associated with BMI, waist circumference, waist\u2010to\u2010hip ratio, fasting glucose, fasting insulin, the homeostatic model assessment of insulin resistance (HOMA\u2010IR), systolic blood pressure, C\u2010reactive protein (CRP), triglycerides, and HDL cholesterol (all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). Plasma cathepsin S levels increased significantly (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.045 for trend) with increasing numbers of MS components after adjustment for potential confounders. In the highest cathepsin S quartile, the MS risk was significantly higher (odds ratio 2.30; 95% confidence interval, 1.89\u20102.78) than in the lowest quartile after adjustment for age, gender, alcohol consumption, smoking, education, physical activity, self\u2010reported CVD, and family history of diabetes. This association remained strong (odds ratio 1.97; 95% confidence interval, 1.72\u20102.48) after controlling further for CRP, adiponectin, HOMA\u2010IR, and BMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Elevated circulating cathepsin S concentrations are strongly and independently associated with MS in overweight and obese Chinese adults. Prospective studies are needed to establish the role of cathepsin S in the development of MS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dmrr.3117","type":"journal-article","created":{"date-parts":[[2018,12,14]],"date-time":"2018-12-14T22:11:58Z","timestamp":1544825518000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Elevated circulating cathepsin S levels are associated with metabolic syndrome in overweight and obese individuals"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1800-4662","authenticated-orcid":false,"given":"Lili","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Endocrinology Huashan Hospital Fudan University  Shanghai China"},{"name":"Institute of Endocrinology and Diabetology Fudan University  Shanghai 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Hospital, School of Medicine Shanghai Jiaotong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renming","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Huashan Hospital Fudan University  Shanghai China"},{"name":"Institute of Endocrinology and Diabetology Fudan University  Shanghai 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