Elevated circulating cathepsin S levels are associated with metabolic syndrome in overweight and obese individuals.

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. We evaluated serum cathepsin S levels in a cross-sectional sample of 781 overweight and obese Chinese adults by ELISA. Glucose, insulin, lipid profile, inflammatory markers, and adipokines were also measured. Cathepsin S was significantly associated with BMI, waist circumference, waist-to-hip ratio, fasting glucose, fasting insulin, the homeostatic model assessment of insulin resistance (HOMA-IR), systolic blood pressure, C-reactive protein (CRP), triglycerides, and HDL cholesterol (all P < 0.05). Plasma cathepsin S levels increased significantly (P = 0.045 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, 1.89-2.78) than in the lowest quartile after adjustment for age, gender, alcohol consumption, smoking, education, physical activity, self-reported CVD, and family history of diabetes. This association remained strong (odds ratio 1.97; 95% confidence interval, 1.72-2.48) after controlling further for CRP, adiponectin, HOMA-IR, and BMI. 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.