Changes of biochemical indexes and proteinuria levels in elderly patients with cerebral small vessel disease / 解放军医学杂志

ABSTRACT

Objective: To observe the characteristics in changes of cystatin C (Cys C), total cholesterol (TC), lipoprotein a [Lp(a)] and proteinuria levels and their significance in patients with cerebral small vessel disease (CSVD). Methods: This was a retrospective study consecutively recruiting 316 patients with CSVD from September 2016 to August 2018 at Lanzhou University Second Hospital, including 113 with white matter hyperintensity (WMH), 101 with lacunar infarction (LI) and 102 with cerebral microbleeds (CMB). One hundred and two elderly people without abnormal head MRI changes and positive signs of nervous system were selected as the control group. Cys C, TC, Lp(a) and proteinuria levels were measured and compared between the groups. Results: Serum Cys C and proteinuria levels in CSVD group [(0.9 ± 0.2) mg/L, 99(31.2%)] were all significantly higher than those in control group [(0.8 ± 0.2) mg/L, 12(11.8%), P<0.05]. While, serum TC levels in CSVD group [(3.9 ± 1.0) mmol/L] was significantly lower than those in control group (P<0.05). Subgroup analysis showed that serum Cys C and proteinuria levels in the WMH group [(0.9 ± 0.2) mg/L, 33(29.2%), respectively], the LI group [(0.9 ± 0.2) mg/L, 36(35.6%), respectively] and the CMB group [(0.9 ± 0.1) mg/L, 30(29.4%), respectively] were significantly higher than those in control group (P<0.05). While, serum TC level s in WMH group, LI group and CMB group [(3.9±1.1) mmol/L, (3.9±1.0) mmol/L, (3.8±0.8) mmol/L, respect ively] were significantly lower than those in control group (P<0.05). After adjustment for confounding factors, multiple logistic regression analysis showed that Cys C and proteinuria were independent risk factors for CSVD (P<0.05). Additionally, subgroup analysis showed that TC was independent protective factor for CMB (P<0.05), Lp(a) was independent risk factor for LI (P<0.05). Conclusions: Cys C, Lp(a) and proteinuria may be risk factors for CSVD, but may not carry the same weight for WMH, LI and CMB. Meanwhile, TC is an independent protective factor for CMB.