Serum cystatin C levels are negatively correlated with post-stroke cognitive dysfunction  

作　　者：Dao-Xia Guo Zheng-Bao Zhu Chong-Ke Zhong Xiao-Qing Bu Li-Hua Chen Tan Xu Li-Bing Guo Jin-Tao Zhang Dong Li Jian-Hui Zhang Zhong Ju Chung-Shiuan Chen Jing Chen Yong-Hong Zhang Jiang He 

机构地区：[1]Department of Epidemiology,School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases,Medical College of Soochow University,Suzhou,Jiangsu Province,China [2]Department of Epidemiology,Tulane University School of Public Health and Tropical Medicine,New Orleans,LA,USA [3]Department of Neurology,Siping Central Hospital,Siping,Jilin Province,China [4]Department of Neurology,the 88th Hospital of People’s Liberation Army,Taian,Shandong Province,China [5]Department of Internal Medicine,Feicheng City People’s Hospital,Feicheng,Shandong Province,China [6]Department of Neurology,Tongliao Municipal Hospital,Inner Mongolia Autonomous Region,China [7]Department of Neurology,Kerqin District First People’s Hospital of Tongliao City,Inner Mongolia Autonomous Region,China [8]Department of Medicine,Tulane University School of Medicine,New Orleans,LA,USA

出　　处：《Neural Regeneration Research》2020年第5期922-928,共7页中国神经再生研究（英文版）

基　　金：supported by the National Natural Science Foundation of China,No.81673263(to YHZ);Ministry of Science and Technology of China,No.2016YFC1307300(to YHZ);a Project of the Priority Academic Program Development of Jiangsu Higher Education Institutions,China(to YHZ)

摘　　要：Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor in animal studies.However,the relationship between CysC levels and cognitive dysfunction in previous studies has revealed different results.This prospective observational study investigated the correlation between serum CysC levels and post-stroke cognitive dysfunction at 3 months.Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE) at 3 months after stroke.According to the MMSE score,308 patients (52.9%) had post-stroke cognitive dysfunction.After adjusting for potential confounding factors,the odds ratio (95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum CysC levels was 0.54 (0.30–0.98),compared with the lowest quartile.The correlation between serum CysC and cognitive dysfunction was modified by renal function status.We observed a negative linear dose-response correlation between CysC and cognitive dysfunction in patients with normal renal function (Plinearity = 0.044),but not in those with abnormal renal function.Elevated serum CysC levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke,especially in those with normal renal function.The current results suggest that CysC is a protective factor for post-stroke cognitive dysfunction,and could be used to treat post-stroke cognitive dysfunction.The CATIS study was approved by the Institutional Review Boards at Soochow University from China (approval No.2012-02) on December 30,2012,and was registered at ClinicalTrials.gov (identifier No.NCT01840072) on April 25,2013.Stroke is the leading cause of death and long-term disability worldwide, and cognitive impairment and dementia are major complications of ischemic stroke. Cystatin C(Cys C) has been found to be a neuroprotective factor in animal studies. However, the relationship between Cys C levels and cognitive dysfunction in previous studies has revealed different results. This prospective observational study investigated the correlation between serum Cys C levels and post-stroke cognitive dysfunction at 3 months. Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke(CATIS). Cognitive dysfunction was assessed using the Mini-Mental State Examination(MMSE) at 3 months after stroke. According to the MMSE score, 308 patients(52.9%) had post-stroke cognitive dysfunction. After adjusting for potential confounding factors, the odds ratio(95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum Cys C levels was 0.54(0.30–0.98), compared with the lowest quartile. The correlation between serum Cys C and cognitive dysfunction was modified by renal function status. We observed a negative linear dose-response correlation between Cys C and cognitive dysfunction in patients with normal renal function(Plinearity = 0.044), but not in those with abnormal renal function. Elevated serum Cys C levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke, especially in those with normal renal function. The current results suggest that Cys C is a protective factor for post-stroke cognitive dysfunction, and could be used to treat post-stroke cognitive dysfunction. The CATIS study was approved by the Institutional Review Boards at Soochow University from China(approval No. 2012-02) on December 30, 2012, and was registered at Clinical Trials.gov(identifier No. NCT01840072) on April 25, 2013.

关 键 词：abnormal RENAL FUNCTION cognitive dysfunction CYSTATIN C ISCHEMIC stroke Mini-Mental State Examination neural regeneration NEUROPROTECTIVE effect normal RENAL FUNCTION 

分 类 号：R449[医药卫生—诊断学] R741[医药卫生—临床医学]