Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：stroke

Publication type: Original Contributions

IF(IF): 10.17

PMID: 35862202 Link To Pubmed Full text Download

Cystatin C is a potent cysteine protease inhibitor that plays pleiotropic roles in human vascular pathophysiology Emerging evidence has demonstrated that circulating cystatin C had a strong association with risk of ischemic stroke (IS) and cystatin C may be associated with CSVD imaging markers (WMH, CMBs) in hospital-based populations. However, few study have investigated the relationship of cystatin C with the total CSVD burden in community-dwelling population.The aim of this study was to investigate the relationship between serum cystatin C levels and the presence and severity of cerebral small vessel disease (CSVD).

Ordinal logistic regression and binary logistic regression models were performed to evaluate the relationship of the categories of cystatin C with CSVD burden and CSVD image markers. Through ordinal logistic regression models, we estimated common odd ratio (cOR) with their 95% confidence intervals (CIs) for total CSVD burden, modified total CSVD burden, modified WMH burden and CMBs burden. For others CSVD image markers, binary logistic regression models were performed and odd ratio (OR) with their 95% CI were presented. Three models were conducted for each outcome. In model 1, no covariate was adjusted. In model 2, age, sex, diabetes, hypertension, total cholesterol, previous dyslipidemia, previous heart disease, previous stroke, current smoking, current drinking, previous antiplatelet and anticoagulants drugs use were adjusted. Model 3 additionally adjusted for estimating glomerular filtration rate (eGFR) based on creatinine. We performed ordinal logistic regression models with restricted cubic splines for the cystatin C (continuous variable) with adjustments for all potential covariates (model 3) to the pattern and magnitude of associations between cystatin C and total CSVD burden or modified total CSVD burden. The 25th percentile of the cystatin C was used as the reference and the 5th, 25th, 50th, 75th, and 95th percentiles of cystatin C were used as the 5 knots for spline.