Higher Levels of Cystatin C Are Associated with Worse Cognitive Function in Older Adults with Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort Cognitive Study

被引：36

作者：

Yaffe, Kristine ^{[1
,2
,3
,4
]}

Kurella-Tamura, Manjula ^{[5
,6
]}

Ackerson, Lynn ^{[7
]}

Hoang, Tina D. ^{[8
]}

Anderson, Amanda H. ^{[9
]}

Duckworth, Mark ^{[10
]}

Go, Alan S. ^{[7
]}

Krousel-Wood, Marie ^{[11
,12
,13
]}

Kusek, John W. ^{[14
]}

Lash, James P. ^{[15
]}

Ojo, Akinlolu ^{[16
,17
]}

Robinson, Nancy ^{[9
]}

Sehgal, Ashwini R. ^{[18
,19
,20
]}

Sondheimer, James H. ^{[21
]}

Steigerwalt, Susan ^{[22
,23
]}

Townsend, Raymond R. ^{[10
]}

机构：

[1] Univ Calif San Francisco, Sch Med, Dept Psychiat, San Francisco, CA 94143 USA

[2] Univ Calif San Francisco, Sch Med, Dept Neurol, San Francisco, CA USA

[3] Univ Calif San Francisco, Sch Med, Dept Epidemiol & Biostat, San Francisco, CA USA

[4] San Francisco VA Med Ctr, San Francisco, CA USA

[5] Stanford Univ, Sch Med, Div Nephrol, Palo Alto, CA 94304 USA

[6] Palo Alto Vet Affairs Med Ctr, Palo Alto, CA USA

[7] Kaiser Permanente, Div Res, Oakland, CA USA

[8] Northern Calif Ctr Res & Educ, San Francisco, CA USA

[9] Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA

[10] Univ Penn, Renal Electrolyte & Hypertens Div, Perelman Sch Med, Philadelphia, PA 19104 USA

[11] Tulane Univ, Dept Med, New Orleans, LA 70118 USA

[12] Tulane Univ, Dept Epidemiol, New Orleans, LA 70118 USA

[13] Ochsner Clin Fdn, Ctr Hlth Res, New Orleans, LA USA

[14] NIDDK, NIH, Bethesda, MD 20892 USA

[15] Univ Illinois, Coll Med, Dept Med, Chicago, IL USA

[16] Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI USA

[17] Univ Michigan, Sch Med, Dept Nephrol, Ann Arbor, MI USA

[18] Case Western Reserve Univ, Dept Med, Cleveland, OH 44106 USA

[19] Case Western Reserve Univ, Dept Biomed Eth, Cleveland, OH 44106 USA

[20] Case Western Reserve Univ, Dept Epidemiol & Biostat, Cleveland, OH 44106 USA

[21] Wayne State Univ, Sch Med, Dept Internal Med, Detroit, MI 48201 USA

[22] St John Hosp & Med Ctr, Div Nephrol & Hypertens, Dept Med, Detroit, MI USA

[23] St John Hosp & Med Ctr, Chron Kidney Dis Clin, Detroit, MI USA

来源：

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY | 2014年 / 62卷 / 09期

基金：

美国国家卫生研究院;

关键词：

cystatin C; cognition; chronic kidney disease; GLOMERULAR-FILTRATION-RATE; ALZHEIMERS-DISEASE; CEREBROSPINAL-FLUID; SERUM CREATININE; BODY-COMPOSITION; ELDERLY PERSONS; RISK-FACTOR; IMPAIRMENT; HEALTH; BRAIN;

D O I：

10.1111/jgs.12986

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

ObjectivesTo determine the association between cognition and levels of cystatin C in persons with chronic kidney disease (CKD). DesignProspective observational study. SettingChronic Renal Insufficiency Cohort Cognitive Study. ParticipantsIndividuals with a baseline cognitive assessment completed at the same visit as serum cystatin C measurement (N=821; mean age 64.9, 50.6% male, 48.6% white). MeasurementsLevels of serum cystatin C were categorized into tertiles; cognitive function was assessed using six neuropsychological tests. Scores on these tests were compared across tertiles of cystatin C using linear regression and logistic regression to examine the association between cystatin C level and cognitive performance (1 standard deviation difference from the mean). ResultsAfter multivariable adjustment for age, race, education, and medical comorbidities in linear models, higher levels of cystatin C were associated with worse cognition on the modified Mini-Mental State Examination, Buschke Delayed Recall, Trail-Making Test Part (Trails) A and Part B, and Boston Naming (P<.05 for all). This association remained statistically significant for Buschke Delayed Recall (P=.01) and Trails A (P=.03) after additional adjustment for estimated glomerular filtration rate (eGFR). The highest tertile of cystatin C was associated with greater likelihood of poor performance on Trails A (odds ratio (OR)=2.17, 95% confidence interval (CI)=1.16-4.06), Trails B (OR=1.89, 95% CI=1.09-3.27), and Boston Naming (OR=1.85, 95% CI=1.07-3.19) than the lowest tertile after multivariate adjustment in logistic models. ConclusionIn individuals with CKD, higher serum cystatin C levels were associated with worse cognition and greater likelihood of poor cognitive performance on attention, executive function, and naming. Cystatin C is a marker of cognitive impairment and may be associated with cognition independent of eGFR.

引用

页码：1623 / 1629

页数：7

共 48 条

[1]

Anderson AH, 2010, J AM SOC NEPHROL, V21, p176A

[2] Comparison of Measured GFR, Serum Creatinine, Cystatin C, and Beta-Trace Protein to Predict ESRD in African Americans With Hypertensive CKD [J].

Bhavsar, Nrupen A. ;

Appel, Lawrence J. ;

Kusek, John W. ;

Contreras, Gabriel ;

Bakris, George ;

Coresh, Josef ;

Astor, Brad C. .

AMERICAN JOURNAL OF KIDNEY DISEASES, 2011, 58 (06) :886-893

[3] Cognitive Disorders and Dementia in CKD: The Neglected Kidney-Brain Axis [J].

Bugnicourt, Jean-Marc ;

Godefroy, Olivier ;

Chillon, Jean-Marc ;

Choukroun, Gabriel ;

Massy, Ziad A. .

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2013, 24 (03) :353-363

[4] EVALUATING STORAGE, RETENTION, AND RETRIEVAL IN DISORDERED MEMORY AND LEARNING [J].

BUSCHKE, H ;

FULD, PA .

NEUROLOGY, 1974, 24 (11) :1019-1025

[5] Cystatin C as a risk factor for Alzheimer disease [J].

Cathcart, HM ;

Huang, R ;

Lanham, IS ;

Corder, EH ;

Poduslo, SE .

NEUROLOGY, 2005, 64 (04) :755-757

[6] Serum cystatin C as a new marker for noninvasive estimation of glomerular filtration rate and as a marker for early renal impairment [J].

Coll, E ;

Botey, A ;

Alvarez, L ;

Poch, E ;

Quintó, L ;

Saurina, A ;

Vera, M ;

Piera, C ;

Darnell, A .

AMERICAN JOURNAL OF KIDNEY DISEASES, 2000, 36 (01) :29-34

[7] Calibration and random variation of the serum creatinine assay as critical elements of using equations to estimate glomerular filtration rate [J].

Coresh, J ;

Astor, BC ;

McQuillan, G ;

Kusek, J ;

Greene, T ;

Van Lente, F ;

Levey, AS .

AMERICAN JOURNAL OF KIDNEY DISEASES, 2002, 39 (05) :920-929

[8] Elevation of cystatin C in susceptible neurons in Alzheimer's disease [J].

Deng, A ;

Irizarry, MC ;

Nitsch, RM ;

Growdon, JH ;

Rebeck, GW .

AMERICAN JOURNAL OF PATHOLOGY, 2001, 159 (03) :1061-1068

[9] Evaluation of the Dade Behring N Latex Cystatin C assay on the Dade Behring Nephelometer II system [J].

Erlandsen, EJ ;

Randers, E ;

Kristensen, JH .

SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION, 1999, 59 (01) :1-8

[10] The Chronic Renal Insufficiency Cohort (CRIC) study: Design and methods [J].

Feldman, HI ;

Appel, LJ ;

Chertow, GM ;

Cifelli, D ;

Cizman, B ;

Daugirdas, J ;

Fink, JC ;

Franklin-Becker, ED ;

Go, AS ;

Hamm, LL ;

He, JA ;

Hostetter, T ;

Hsu, CY ;

Jamerson, K ;

Joffe, M ;

Kusek, JW ;

Landis, JR ;

Lash, JP ;

Miller, ER ;

Mohler, ER ;

Muntner, P ;

Ojo, AO ;

Rahman, M ;

Townsend, RR ;

Wright, JT .

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2003, 14 (07) :S148-S153

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