Youyi Wang1, Ying Zhang1, Qinghua Ma2, Congju Wang3, Yong Xu1, Hongpeng Sun4, Yana Ma5. 1. Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, PR China. 2. The 3rd People's Hospital of Xiangcheng District, Suzhou, PR China. 3. Centers for Disease Control and Prevention of Suzhou High-tech Zone, Beijing, PR China. 4. Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, PR China. Electronic address: hpsun@suda.edu.cn. 5. Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, PR China. Electronic address: yanama@suda.edu.cn.
Abstract
BACKGROUND: The association between cystatin C and risk of ischemic stroke is inconsistent and the cut-off values of cystatin C are diverse in different articles. We aimed to investigate the association between cystatin C levels and the development of ischemic stroke and to explore the clinical cut-off values of serum cystatin C levels for ischemic stroke. METHODS: This prospective cohort study included 7658 participants from the China Health and Retirement Longitudinal Study who were free of cardiovascular diseases and cancer at baseline. A decision-tree model was used to find reasonable cut-off values for cystatin C levels. Logistic regression models were used to analyze the association between different levels of cystatin C and the risk of ischemic stroke. RESULTS: The whole cohort was divided into the following 3 groups according to the decision tree: group-low (<.901 mg/L), group-moderate (.901∼1.235 mg/L), and group-high (>1.235 mg/L). After 4 years of follow-up, we identified 156 cases of ischemic stroke. After adjusting for potential confounding factors, the odds ratios (95% confidence intervals) of ischemic stroke were 1.637 (1.048-2.556) for group-moderate and 2.326 (1.285-4.210) for group-high) compared with the low group of cystatin C. Subgroup analyses showed that the association between cystatin C levels and the incidence of ischemic stroke was more pronounced in males or old people than in females or young people. CONCLUSIONS: We found 2 suitable cut-off values for serum cystatin C levels and found that high levels of cystatin C were associated with an increased risk of ischemic stroke.
BACKGROUND: The association between cystatin C and risk of ischemic stroke is inconsistent and the cut-off values of cystatin C are diverse in different articles. We aimed to investigate the association between cystatin C levels and the development of ischemic stroke and to explore the clinical cut-off values of serum cystatin C levels for ischemic stroke. METHODS: This prospective cohort study included 7658 participants from the China Health and Retirement Longitudinal Study who were free of cardiovascular diseases and cancer at baseline. A decision-tree model was used to find reasonable cut-off values for cystatin C levels. Logistic regression models were used to analyze the association between different levels of cystatin C and the risk of ischemic stroke. RESULTS: The whole cohort was divided into the following 3 groups according to the decision tree: group-low (<.901 mg/L), group-moderate (.901∼1.235 mg/L), and group-high (>1.235 mg/L). After 4 years of follow-up, we identified 156 cases of ischemic stroke. After adjusting for potential confounding factors, the odds ratios (95% confidence intervals) of ischemic stroke were 1.637 (1.048-2.556) for group-moderate and 2.326 (1.285-4.210) for group-high) compared with the low group of cystatin C. Subgroup analyses showed that the association between cystatin C levels and the incidence of ischemic stroke was more pronounced in males or old people than in females or young people. CONCLUSIONS: We found 2 suitable cut-off values for serum cystatin C levels and found that high levels of cystatin C were associated with an increased risk of ischemic stroke.