TY - JOUR T1 - Cystatin C and subclinical brain infarction. JF - J Am Soc Nephrol Y1 - 2005 A1 - Seliger, Stephen L A1 - Longstreth, W T A1 - Katz, Ronit A1 - Manolio, Teri A1 - Fried, Linda F A1 - Shlipak, Michael A1 - Stehman-Breen, Catherine O A1 - Newman, Anne A1 - Sarnak, Mark A1 - Gillen, Daniel L A1 - Bleyer, Anthony A1 - Siscovick, David S KW - Age Factors KW - Aged KW - Aged, 80 and over KW - Biomarkers KW - Brain Infarction KW - Confidence Intervals KW - Creatinine KW - Cross-Sectional Studies KW - Cystatin C KW - Cystatins KW - Disease Progression KW - Female KW - Geriatric Assessment KW - Humans KW - Incidence KW - Ischemic Attack, Transient KW - Magnetic Resonance Imaging KW - Male KW - Odds Ratio KW - Predictive Value of Tests KW - Prognosis KW - Risk Assessment KW - Sensitivity and Specificity KW - Severity of Illness Index KW - Sex Factors KW - Survival Analysis AB -

Subclinical brain infarcts (SBI) are common in the elderly and are associated with covert neurologic and cognitive impairment. Although renal impairment is associated with accelerated cerebrovascular disease and an increased risk for clinically apparent brain infarct, few studies have examined the relationship between renal function and SBI, and these may have been limited by the inaccuracy of creatinine as a renal function marker. A cross-sectional study was performed among older adults in the Cardiovascular Health Study to examine associations between SBI and two serum markers of renal function: Serum creatinine (SCr) and cystatin C (CysC). Patients had cranial magnetic resonance imaging and renal markers measured in 1992 to 1993. Logistic regression was used to estimate the associations between renal function (estimated by 1/SCr and 1/CysC) and SBI, controlling for potential confounding factors. SBI were present in 789 (28.7%) of 2784 participants. A linear association with SBI was observed for 1/CysC (per 1-SD decrement; odds ratio [OR] 1.20; 95% confidence interval [CI] 1.09 to 1.32; P < 0.001) but not for 1/SCr (OR 1.08; 95% CI 0.98 to 1.19; P = 0.14), for which a quadratic U-shaped association was suggested (P = 0.004). In a model with both markers, 1/CysC was linearly associated with SBI (OR 1.26; P < 0.001), whereas 1/SCr was not (OR 1.06; P = 0.3). The prevalence of SBI was directly associated with quintile of CysC, whereas the association between SCr and SBI was U-shaped, with greater prevalence at high and low levels. Compared with creatinine, CysC, a novel marker of renal function, has a stronger and more direct association with SBI in the elderly.

VL - 16 IS - 12 U1 - https://www.ncbi.nlm.nih.gov/pubmed/16236809?dopt=Abstract ER -