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Serum Cystatin C is Associated with Depression After Intracerebral Hemorrhage
Lei Zhu1,2, Chuanqing Yu2, Yueyue Chang2
1Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.
Insights
Elevated serum Cystatin C (Cys C) levels are linked to a higher risk of depression after intracranial hemorrhage (ICH). Cys C may serve as a biomarker for predicting post-ICH depression.
Area of Science:
- Neuroscience
- Biochemistry
- Clinical Medicine
Background:
- Cystatins, including Cystatin C (Cys C), play roles in nervous system health and injury.
- Cys C has been implicated in brain injury and inflammation.
- Understanding factors predicting post-intracranial hemorrhage (ICH) depression is crucial.
Purpose of the Study:
- To investigate the association between serum Cys C levels and the development of depression after ICH.
- To evaluate Cys C as a potential biomarker for post-ICH depression.
Main Methods:
- A cohort of 337 ICH patients were recruited and followed for three months.
- Post-stroke depression (PSD) was diagnosed using DSM-IV criteria and the HAMD scale.
- Serum Cys C levels were measured within 24 hours of admission.
Main Results:
- 93 patients (27.6%) developed depression three months post-ICH.
- Depressed patients exhibited significantly higher Cys C levels compared to non-depressed patients (1.32 vs 1.01, p<0.001).
- Higher Cys C levels were independently associated with ICH-related depression (OR=3.195). A Cys C cut-off of 0.730 showed 84.5% sensitivity and 88.4% specificity (AUC=0.880).
Conclusions:
- Elevated serum Cys C concentrations are independently associated with depression three months after ICH.
- Cys C levels measured at admission may serve as a predictive biomarker for post-ICH depression.
Purpose:
Cystatins are associated with neuronal degeneration and nervous system healing. Cystatin C (Cys C) has recently been linked to brain injury and immunological inflammation. This study aimed to determine the relationship between serum Cys C levels and depression following intracranial hemorrhage (ICH).
Patients And Methods:
Between September 2020 and December 2022, 337 patients with ICH were sequentially recruited and followed up for three months. The post-stroke depression (PSD) and non-PSD groups were separated based on the 17-item Hamilton Depression Rating Scale (HAMD). The PSD diagnosis was established based on the DSM-IV criteria. Cys-C levels were documented within twenty-four hours of admission.
Results:
Three months after ICH, 93 (27.6%) of 337 enrolled patients were diagnosed with depression. The Cys C levels were significantly higher in depressed patients than in nondepressed patients after ICH (1.32 vs 1.01; p<0.001). After adjusting for potential confounding variables, depression after ICH was associated with the highest quartile of Cys C levels (odds ratio (OR) = 3.195, 95% CI: 1.562-6.536; p=0.001). The receiver operating characteristic curve (ROC) curve predicted that the ideal cut-off for CysC levels as a predictor of depression after ICH would be 0.730, resulting in 84.5% sensitivity and 88.4% specificity, with an area under curve (AUC) of 0.880 (95% CI: 0.843-0.917; p< 0.0001).
Conclusion:
Increased CysC concentrations were independently related to depression three months after ICH, highlighting that CysC levels at admission may be a potential biomarker for predicting the onset of depression following ICH.
