Serum cystatin C level and risk of hypertensive cerebral hemorrhage

Objective To investigate the relationship between serum cystatin C (CysC) level and hypertensive intracerebral hemorrhage (HICH). Methods The patients with HICH and healthy controls were enrolled. The demographic and clinical data were collected. Immunoturbidimetric assay was used to detect serum CysC level. Results A total of 94 consecutive patients with HICH and 131 healthy controls were enrolled. The baseline systolic blood pressure (168.57±28.64 mmHg vs. 128.13±16.23 mmHg; t=-13.442, P<0.001; 1 mmHg=0.133 kPa), diastolic blood pressure (95.56±14.68 mmHg vs. 76.80±8.76 mmHg; t=-11.965, P<0.001), fasting plasma glucose (6.24±1.83 mmol/L vs. 5.22±1.13 mmol/L; t=-4.234, P<0.001), and serum CysC level (1.02±0.26 mg/L vs. 0.91±0.13 mg/L, P<0.001) in the HICH group were significantly higher than those in the control group. Multivariable logistic regression analysis showed that baseline systolic blood pressure ≥140 mmHg(odds ratio [OR] 12.523, 95% confidence interval [CI] 5.353-29.299; P<0.01), diastolic blood pressure ≥90 mmHg (OR 3.968, 95% CI 1.792-8.784; P<0.01) and serum CysC level ≥1.09 mg/L(OR 3.279, 95% CI 1.336-8.050; P<0.05) were the independent risk factors for HICH. In patients with HICH, the CysC serum level (1.13±0.26 mg/L) in the bleeding ≥30 ml group was higher than that in the bleeding <30 ml group (0.99±0.25 mg/L; P<0.001) and the control group (0.91±0.13 mg/L; P<0.001). The serum CysC level in the bleeding volume <30 ml was higher than that in the control group (P=0.004). There were positive correlations between serum CysC and age, creatinine, urea, and uric acid (all P<0.01); there were negative correlations between serum CysC level and the estimated glomerular filtration rate (P<0.01). Multivariable linear regression analysis showed that age, creatinine, urea and uric acid were independent associated with the serum CysC level (all P<0.05). Conclusions The increased serum CysC level is correlated with the amount of bleeding in patients with HICH. The increased serum CysC level is an independent risk factor for HICH. Key words: Cystatin C; Cerebral Hemorrhage; Hypertension; Risk Factors