Relationship Between White Matter Ischemic Lesions And Serum Cystatin C Level In Elderly Patients

ObjectiveTo investigate the association between white matter ischemic lesion (WMIL)severity and serum cystatin C (Cys-C) level in elderly WMIL patients (>85 years old).MethodsWMIL patients who were diagnosed and hospitalized from January 2013 to January 2017 were selected. White matter ischemic lesion is also called leukoaraiosis. All of them were identified on MRI scans. According to age-related white matter changes (ARWMC)scale (1-30 score) for WMILs severity assessment,patients were divided into three groups :mild,(1-4 score),moderate,(5-8 score) and severe (>=9 score) . We collected patients clinical information such as age, sex, history of hypertension, diabetes mellitus (DM),nephrosis, coronary heart disease (CHD), cronic bronchitis, hyperlipidaemia, lacunar infarction (LI) and serum level of cysteine proteinasc inhibitors namely cystatin C,crcatininc, urea, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein. Data were analyzed using SPSS, version 17.0. Compare these datas among the three groups. Orderly classification logistic regression were used to analyze the association between serum Cys-C level and the severity of WMILs. All tests were considered significance if p<0.05.ResultsIn elderly patients (>85 years old) , compare the history of diabetes mellitus and serum Cys-C level among the three groups, the difference was statistically significant (P <0.05) . Compared with mild group, the incidence of diabetes in severe group was obviously increased. [13 (40. 6) vs 6 (11.8) , P<0. 01 ]. Serum level of cystatin C in severe group was obviously higher than that in mild and moderate groups [1.4 (0. 8) mg/L vs 1.2 (0. 4)mg/L?1.2 (0. 5) mg/L, P<0. 01, P<0. 01 ] . Bring serum level of cystatin C and history of hypertension into logistic regression, orderly classification logistic regression suggests in the aged patients (>85 years old) serum cystatin C level and history of diabetes is closely related to the severity of the WMILs (OR=3. 18, 95%CI: 0. 497-1.819, P=0. 001);(OR=3.78, 95%CI:0.546-2.115, P=0. 001) .In the accordance with Spearman rank correlation analysis, the severity of WMILs was positively correlated with the serum level of Cys-C (r=0. 218,P=0.012).ConclusionsIncreased serum Cys-C level in elderly patients (<85 years old) may be significantly associated with the severity of WMILs.