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

Area of Science:

• Neurology
• Biochemistry
• Nephrology

Background:

• Stroke is a leading cause of death and disability, with cognitive impairment a common complication.
• Cystatin C (CysC) shows neuroprotective potential, but its role in post-stroke cognitive dysfunction is unclear.
• Previous studies on CysC and cognitive dysfunction have yielded conflicting results.

Purpose of the Study:

• To investigate the association between serum CysC levels and cognitive dysfunction 3 months post-ischemic stroke.
• To explore whether renal function modifies the relationship between CysC and cognitive outcomes.
• To assess CysC as a potential biomarker or therapeutic target for post-stroke cognitive impairment.

Main Methods:

• Prospective observational study of 638 patients from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).
• Serum CysC levels were measured, and cognitive function assessed using the Mini-Mental State Examination (MMSE) at 3 months.
• Statistical analyses adjusted for confounding factors, including subgroup analysis by renal function.

Main Results:

• Over half of patients (52.9%) exhibited post-stroke cognitive dysfunction.
• Elevated serum CysC levels were associated with a significantly lower risk of cognitive dysfunction (OR 0.54; 95% CI 0.30-0.98) in the highest quartile compared to the lowest.
• A negative correlation between CysC and cognitive dysfunction was observed in patients with normal renal function (P_linearity = 0.044), but not in those with impaired renal function.

Conclusions:

• Elevated serum CysC levels are linked to a reduced risk of cognitive dysfunction 3 months after acute ischemic stroke.
• Cystatin C demonstrates a neuroprotective role, particularly in patients with normal renal function.
• CysC may serve as a valuable biomarker and potential therapeutic agent for preventing or treating post-stroke cognitive dysfunction.