Li Zhiming, Wang Fei, Liu Jincheng, Xiong Benbo, Wang Han, Wang Zijie, Hu Xiao, Li Qi
Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China; Department of Neurology, Xiangyang Hospital of Traditional Chinese Medicine, Xiangyang, Hubei, China.
J Prev Alzheimers Dis. 2025 Aug;12(7):100190. doi: 10.1016/j.tjpad.2025.100190. Epub 2025 Apr 24.
It remains unclear whether the difference between the estimated glomerular filtration rate based on cystatin C and creatinine (eGFRdiff) is associated with cerebral small vessel disease (CSVD). We investigated the correlation of eGFRdiff with SCVD and further evaluated the mediating role of blood pressure.
This prospective cohort study included 35,590 neurologically healthy participants at baseline (2006 to 2010) from the UK Biobank. eGFRdiff is divided into two indicators: absolute difference (eGFRabdiff) and ratio (eGFRrediff) based on the calculation between cystatin C and creatinine. CSVD was assessed by calculating white matter hyperintensity volume (WMHV) from T2-FLAIR brain MRI scans (conducted between 2014 and 2021), with values normalized to intracranial volume and log-transformed. Multiple linear regression models and mediation analysis was used to evaluate the associations of eGFRdiff with WMHV.
Participants with negative eGFRabdiff had higher WMHV (β = 0.07, 95 % confidence interval [CL] = 0.04 ∼ 0.10), while participants with positive eGFRabdiff had smaller WMHV (β = -0.05, 95 %CL = -0.09 ∼ -0.02), compared to midrange eGFRabdiff group. Meanwhile, participants with eGFRrediff ≤ 0.7 had higher WMHV compared with participants with eGFRrediff > 0.7 (β = 0.08, 95 %CL = 0.01∼ 0.15) .In addition, hypertension mediated the associations between eGFRdiff and WMHV (12.6 % ∼13.2 %).
eGFRdiff was independently associated with WMHV. Our findings suggested that monitoring eGFRdiff has potential benefits in identifying the burden of CSVD in the general population in future.
基于胱抑素C和肌酐的估计肾小球滤过率差异（eGFRdiff）与脑小血管病（CSVD）之间是否存在关联尚不清楚。我们研究了eGFRdiff与CSVD的相关性，并进一步评估了血压的中介作用。
这项前瞻性队列研究纳入了英国生物银行中35590名基线时（2006年至2010年）神经系统健康的参与者。根据胱抑素C和肌酐之间的计算，eGFRdiff分为两个指标：绝对差值（eGFRabdiff）和比值（eGFRrediff）。通过计算T2-FLAIR脑MRI扫描（2014年至2021年进行）中的白质高信号体积（WMHV）来评估CSVD，其值经颅内体积标准化并进行对数转换。使用多元线性回归模型和中介分析来评估eGFRdiff与WMHV的关联。
与中等范围eGFRabdiff组相比，eGFRabdiff为负的参与者WMHV更高（β = 0.07，95%置信区间[CI] = 0.04 ∼ 0.10），而eGFRabdiff为正的参与者WMHV更小（β = -0.05，95%CI = -0.09 ∼ -0.02）。同时，与eGFRrediff > 0.7的参与者相比，eGFRrediff ≤ 0.7的参与者WMHV更高（β = 0.08，95%CI = 0.01 ∼ 0.15）。此外，高血压介导了eGFRdiff与WMHV之间的关联（12.6% ∼ 13.2%）。
eGFRdiff与WMHV独立相关。我们的研究结果表明，监测eGFRdiff在未来识别普通人群中CSVD负担方面具有潜在益处。
