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Cystatin C predicts cognitive decline in multiple system atrophy: A 1-year prospective cohort study
Lingyu Zhang1,2, Ruicen Li1, Yanbing Hou2
1Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
Background:
Accumulating evidence has suggested that cystatin C is associated with cognitive impairment in patients with neurodegenerative diseases. However, the association between cystatin C and cognitive decline in patients with multiple system atrophy (MSA) remains largely unknown.
Objectives:
The objective was to determine whether cystatin C was independently associated with cognitive decline in patients with early-stage MSA.
Methods:
Patients with MSA underwent evaluation at baseline and the 1-year follow-up. Cognitive function was evaluated with Montreal cognitive assessment (MoCA). Changes in the MoCA score and the absolute MoCA score at the 1-year assessment were considered the main cognitive outcome. The cystatin C concentrations in patients with MSA and age, sex, and body mass index matched-healthy controls (HCs) were measured. A multiple linear regression model was used to test the association between cystatin C and cognitive decline.
Results:
A total of 117 patients with MSA and 416 HCs were enrolled in the study. The cystatin C levels were significantly higher in patients with MSA than in HCs (p < 0.001). Cystatin C levels were negatively correlated with MoCA score at baseline and at 1-year follow-up. Multiple linear regression model adjusted for potential confounders showed that baseline cystatin C levels were significantly associated with the MoCA score (p = 0.004) or change in the MoCA score (p = 0.008) at 1-year follow-up.
Conclusion:
Our results suggested that cystatin C may serve as a potential biomarker of cognitive decline in patients with early-stage MSA.
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