Association Between Cystatin C and the Risk of Ischemic Stroke: a Systematic Review and Meta-analysis

Wang, Yan; Li, Wei; Yang, Jun; Zhang, Mijuan; Tian, Chengming; Ma, Mengmeng; Zhang, Qian

doi:10.1007/s12031-019-01373-1

Cited by 27 publications

(18 citation statements)

References 35 publications

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“…Our study showed that increased diastolic blood pressure was associated with END in CCE patients, which is consistent with previous studies. Several studies have shown that cystatin C is associated with IS and could be considered a risk factor for AIS (Wang, Li, et al., 2019). Additionally, cystatin C is also independently associated with shorter survival in IS patients (Winovich et al., 2017).…”

Section: Discussionmentioning

confidence: 99%

Early neurological deterioration in cardiogenic cerebral embolism due to nonvalvular atrial fibrillation: Predisposing factors and clinical implications

Liu

2020

Brain and Behavior

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Purpose The aim of the study was to investigate factors which may predispose patients to early neurological deterioration (END) and explore peripheral biomarkers for the prediction of END in cardiogenic cerebral embolism (CCE) patients. Methods Patients diagnosed with CCE within 24 hr of onset between January 2017 and January 2019 were included in this study. END was defined as an increase of ≥2 on the National Institutes of Health Stroke Scale (NIHSS) or the emergence of new neurological symptoms within 3 days of admission. Binary logistic regression was used to investigate the factors associated with END. Receiver operating characteristic (ROC) curves were then generated to determine the predictive value of the potential biomarkers and the optimal cutoff values. Results Of the 129 (male, 55.81%; mean age 71.85 ± 11.99 years) CCE patients, 55 patients with END were identified. Hemorrhage transformation (HT), coronary heart disease (CHD), diastolic blood pressure, cystatin C levels, NIHSS score, and platelet‐to‐lymphocyte ratio (PLR) at admission were independently associated with END. A peripheral cystatin C level ≥ 1.41 mg/L and a PLR ≥ 132.97 were predictive factors for END in CCE patients. The lymphocyte‐to‐monocyte ratio (LMR) was negatively independently associated with HT, and LMR < 2.31 may predict the occurrence of HT in patients with CCE. Conclusions Of the potential predisposing factors considered, increased cystatin C and PLR were associated with END within 3 days of CCE, and a decreased LMR may have predictive value for HT in CCE patients.

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Section: Discussionmentioning

confidence: 99%

Early neurological deterioration in cardiogenic cerebral embolism due to nonvalvular atrial fibrillation: Predisposing factors and clinical implications

Liu

2020

Brain and Behavior

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“…[ 8 , 9 ] Serum cystatin C (Cys-C), as a biomarker of renal injury, is a more specific and sensitive endogenous indicator. [ 10 – 12 ] However, no study has reported the association between Cys-C levels and renal damage among patients with CHB.…”

Section: Introductionmentioning

confidence: 99%

Association between serum Cystatin C and renal injury in patients with chronic hepatitis B

Zheng

Liu

Hao³

et al. 2020

Medicine

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To explore the association between serum cystatin C (Cys-C) and renal damage in patients with chronic hepatitis B. We retrospectively analyzed the clinical data of 425 patients with chronic hepatitis B virus (HBV) infection. Liver stiffness measured by FibroScan was used to diagnosis liver fibrosis. Cys-C levels were detected via latex-enhanced immunoturbidimetric assay. A total of 425 patients were enrolled. Among them, 217 were patients with CHB with an eGFR > 90 mL/min/1.73 m 2 and 208 with an eGFR ≤90 mL/min/1.73 m 2 . Cys-C levels significantly differed in patients with eGFR > 90 mL/min/1.73 m 2 compared with patients with eGFR ≤90 mL/min/1.73 m 2 (0.81 ± 0.05 vs 1.05 ± 0.06 mg/L, P < .001). Moreover, the Cys-C levels were 0.82 ± 0.04 mg/L in patients without liver fibrosis, 0.98 ± 0.05 mg/L in patients with mild liver fibrosis, 1.05 ± 0.08 mg/L in patients with advanced liver fibrosis, and 1.12 ± 0.07 mg/L in patients with liver cirrhosis ( P < .001). Multivariate analyses were conducted to explore the independent factors associated with a decreased eGFR. Multivariate analysis suggested that T2DM ( P = .032), liver fibrosis ( P = .013), and Cys-C level ( P = .035) were the independent factors associated with the decreased eGFR in patients with CHB. While age ( P = .020) and Cys-C level ( P = .001) were the independent factors associated with the decreased eGFR in patients with CHB-related fibrosis. The fibrosis group had significantly higher Cys-C levels than those without fibrosis. Routine monitoring of Cys-C levels is of positive significance in preventing the development of renal impairment of CHB patients.

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“…Finally, the microenvironment of most solid tumor is acidic due to poor diffusion and increased fermentative metabolism, and the extracellular pH as low as pH 6.5 has been reported 37 . As Cst-3 has been reported to play roles on all above-mentioned pathological processes 6,[38][39][40][41][42][43][44] , it is conceivable that HS might regulate Cst-3 functions in these processes.…”

Section: Discussionmentioning

confidence: 99%

“…Clinically, Cst-3 is used as a marker for evaluation of kidney disease because serum cystatin C concentration correlates with glomerular filtration rate 5 . Recently it has also been proposed as a predictor for cardiovascular risk 6 .…”

mentioning

confidence: 99%

pH-dependent and dynamic interactions of cystatin C with heparan sulfate

Zhang

et al. 2021

Commun Biol

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Cystatin C (Cst-3) is a potent inhibitor of cysteine proteases with diverse biological functions. As a secreted protein, the potential interaction between Cst-3 and extracellular matrix components has not been well studied. Here we investigated the interaction between Cst-3 and heparan sulfate (HS), a major component of extracellular matrix. We discovered that Cst-3 is a HS-binding protein only at acidic pH. By NMR and site-directed mutagenesis, we identified two HS binding regions in Cst-3: the highly dynamic N-terminal segment and a flexible region located between residue 70-94. The composition of the HS-binding site by two highly dynamic halves is unique in known HS-binding proteins. We further discovered that HS-binding severely impairs the inhibitory activity of Cst-3 towards papain, suggesting the interaction could actively regulate Cst-3 activity. Using murine bone tissues, we showed that Cst-3 interacts with bone matrix HS at low pH, again highlighting the physiological relevance of our discovery.

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Association Between Cystatin C and the Risk of Ischemic Stroke: a Systematic Review and Meta-analysis

Cited by 27 publications

References 35 publications

Early neurological deterioration in cardiogenic cerebral embolism due to nonvalvular atrial fibrillation: Predisposing factors and clinical implications

Early neurological deterioration in cardiogenic cerebral embolism due to nonvalvular atrial fibrillation: Predisposing factors and clinical implications

Association between serum Cystatin C and renal injury in patients with chronic hepatitis B

pH-dependent and dynamic interactions of cystatin C with heparan sulfate

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