Xu Lijun, Xu Weihao, Qin Lijie
Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou 463599, China.
Haikou Cadre's Sanitarium of Hainan Military Region, Haikou 570203, China; Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, China.
J Nutr Health Aging. 2025 Mar;29(3):100484. doi: 10.1016/j.jnha.2025.100484. Epub 2025 Jan 9.
This study aimed to examine the associations of cystatin C, cystatin C estimated glomerular filtration rate (eGFRcys), and the difference between eGFRs (eGFRdiff) using cystatin C and creatinine levels with incident motoric cognitive risk syndrome (MCR).
We utilized data from two nationally representative cohort studies, the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015) and the US Health and Retirement Study (HRS, 2010-2018). Baseline serum cystatin C and creatinine levels were measured, and eGFRcys and creatinine estimated GFR (eGFRcr) were calculated. MCR was defined as subjective cognitive complaints plus objectively measured slow gait speed. Multivariable logistic models were used to investigate the longitudinal associations between kidney function measurements and incident MCR.
In CHARLS (N = 2,085) and HRS (N = 1,240) cohorts, 7.4% and 7.2% developed MCR over follow-up. Each SD increment in serum cystatin C level was associated with elevated incident MCR odds, and an inverse association of eGFRcys with incident MCR was observed in both cohorts after multivariable adjustment and meta-analyses. The association between serum cystatin C and incident MCR remained significant even after adjusting for serum creatinine, suggesting that cystatin C is independently associated with MCR, regardless of kidney function levels. Additionally, each SD decrease in the absolute value of eGFRdiff was associated with lower odds of incident MCR among CHARLS participants.
Cystatin C and eGFRcys were correlated with an elevated MCR risk in two distinct populations. Specifically, eGFRdiff also related to incident MCR among Chinese older adults. Monitoring cystatin C-based kidney function could have significant clinical utility for identifying incident MCR risk, and represents a potential intervention target for healthier cognitive aging.
本研究旨在探讨胱抑素C、胱抑素C估算肾小球滤过率（eGFRcys）以及使用胱抑素C和肌酐水平得出的估算肾小球滤过率差值（eGFRdiff）与新发运动性认知风险综合征（MCR）之间的关联。
我们使用了两项具有全国代表性的队列研究数据，即中国健康与养老追踪调查（CHARLS，2011 - 2015年）和美国健康与退休研究（HRS，2010 - 2018年）。测量了基线血清胱抑素C和肌酐水平，并计算了eGFRcys和肌酐估算肾小球滤过率（eGFRcr）。MCR定义为主观认知主诉加上客观测量的缓慢步态速度。使用多变量逻辑模型来研究肾功能测量值与新发MCR之间的纵向关联。
在CHARLS队列（N = 2085）和HRS队列（N = 1240）中，分别有7.4%和7.2%的参与者在随访期间发展为MCR。血清胱抑素C水平每增加1个标准差，新发MCR的几率就会升高，并且在多变量调整和荟萃分析后，两个队列中均观察到eGFRcys与新发MCR呈负相关。即使在调整血清肌酐后，血清胱抑素C与新发MCR之间的关联仍然显著，这表明无论肾功能水平如何，胱抑素C都与MCR独立相关。此外，在CHARLS参与者中，eGFRdiff绝对值每降低1个标准差，新发MCR的几率就会降低。
胱抑素C和eGFRcys与两个不同人群中MCR风险升高相关。具体而言，eGFRdiff也与中国老年人新发MCR有关。监测基于胱抑素C的肾功能对于识别新发MCR风险可能具有重要的临床应用价值，并且代表了实现更健康认知衰老的潜在干预靶点。
