Correlation Of Serum Cystatin C And White Matter Lesions In Ischemic Stroke Patients

Objective:White matter lesions (WMLs) was small vessel disease with high prevalence. It had been proved that kidney function was related to small vessel disease, and Cystatin C(Cys C) was a sensitive indicator of kidney function. This study was to analyze the correlation between serum cystatin C and white matter lesions in ischemic stroke patients.Methods:We enrolled 837 consecutive patients with acute ischemic stroke who underwent MRI in Neurology Department in PLA General Hospital from January 2012 to December 2014. Fazekas scale was used to evaluate the severity of peri ventricular white matter lesions(PWMLs) and deep white matter lesions(DWMLs). The serum cystatin level and other related factors were compared among different grades of PWMLs and DWMLs respectively. Logistic regression was employed to find risk factors of WMLs.Results:(1)The severity of periventricular and deep white matter lesions are positively correlated(x2=744.828,P<0.05).(2)PWMLs of different grades are significanly different in age, hypertension, smoking, drinking, systolic blood pressure(SBP), Serum creatinine(SCr), Cystatin C, and BMI (F/χ2= 120.891,33.726,14.186,22.051,8.552,26.545,110.998,3.35; P=0.000,0.000, 0.003,0.000,0.000,0.000,0.000,0.019). DWMLs of different grades are significanly different in age, hypertension, diabetes, smoking, SBP, TG, Hcy, SC, Cys C, and BMI(F/x2=174.512,20.771,9.941,9.024, 24.595,12.933,12.424,4.097,67.483,3.127;P=0.000,0.000,0.019,0.029,0.000, 0.005,0.006,0.007,0.000,0.025).(3)Cystatin C was not related with the severity of PWMLs(OR=1.438, 95%CI:-0.234-0.943, P>0.05) or DWMLs(OR=0.993,95%CI:-0.567-0.553, P> 0.05).(4)The severity of PWMLs was independently related with age(OR=1.090, 95%CI:0.073-0.099,P<0.05) and hypertension (OR=1.699,95%CI:0.242-0.818, P<0.05). The severity of DWMLs was independently associated with age (OR=1.074, 95%CI:0.059-0.083, P<0.05), hypertension (OR=1.353,95%CI:0.017-0.588, P<0.05), and SBP (OR=1.008,95%CI:0.001-0.015, P<0.05).Conclusions:Serum cystatin C level increased with severity of WMLs in patients with ischemic stroke, while serum cystatin C level is not independent risk factor of WMLs. Age and hypertension were independently associated with the severity of PWMLs and DWMLs.