| Abstract: | Stroke is the leading cause of death and long-term disability worldwide, and cognitive impairment and dementia are major complications of ischemic stroke. Cystatin C(Cys C) has been found to be a neuroprotective factor in animal studies. However, the relationship between Cys C levels and cognitive dysfunction in previous studies has revealed different results. This prospective observational study investigated the correlation between serum Cys C levels and post-stroke cognitive dysfunction at 3 months. Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke(CATIS). Cognitive dysfunction was assessed using the Mini-Mental State Examination(MMSE) at 3 months after stroke. According to the MMSE score, 308 patients(52.9%) had post-stroke cognitive dysfunction. After adjusting for potential confounding factors, the odds ratio(95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum Cys C levels was 0.54(0.30–0.98), compared with the lowest quartile. The correlation between serum Cys C and cognitive dysfunction was modified by renal function status. We observed a negative linear dose-response correlation between Cys C and cognitive dysfunction in patients with normal renal function(Plinearity = 0.044), but not in those with abnormal renal function. Elevated serum Cys C levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke, especially in those with normal renal function. The current results suggest that Cys C is a protective factor for post-stroke cognitive dysfunction, and could be used to treat post-stroke cognitive dysfunction. The CATIS study was approved by the Institutional Review Boards at Soochow University from China(approval No. 2012-02) on December 30, 2012, and was registered at Clinical Trials.gov(identifier No. NCT01840072) on April 25, 2013. |
