文献类型：期刊文献

英文题名：Association Cystatin C and Risk of Stroke in Elderly Patients With Obstructive Sleep Apnea: A Prospective Cohort Study

作者：Su, Xiaofeng[1,2,3];Gao, Yinghui[4];Xu, Weihao[5,6];Li, JianHua[5,6];Chen, Kaibing[7];Gao, Yan[8];Guo, JingJing[9];Zhao, LiBo[1,2];Wang, Huanhuan[3];Qian, Xiaoshun[1,2];Lin, Junling[10];Han, Jiming[3];Liu, Lin[1,2]

第一作者：Su, Xiaofeng

通信作者：Liu, L[1];Liu, L[2];Han, JM[3];Lin, JL[4]

机构：[1]Chinese Peoples Liberat Army Gen Hosp, Dept Pulm & Crit Care Med, Med Ctr 2, Beijing, Peoples R China;[2]Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing, Peoples R China;[3]Yanan Univ, Med Coll, Yanan, Peoples R China;[4]Peking Univ, Int Hosp, PKU UPenn Sleep Ctr, Beijing, Peoples R China;[5]Chinese Peoples Liberat Army Gen Hosp, Dept Cardiol, Med Ctr 2, Beijing, Peoples R China;[6]Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing, Peoples R China;[7]Gansu Univ Chinese Med, Affiliated Hosp, Sleep Ctr, Lanzhou, Peoples R China;[8]960th Hosp PLA, Dept Gen Practice, Jinan, Peoples R China;[9]Peking Univ, Peoples Hosp, Sleep Med Ctr, Dept Resp & Crit Care Med, Beijing, Peoples R China;[10]Capital Med Univ, Beijing Chaoyang Hosp, Dept Pulm & Crit Care Med, Beijing, Peoples R China

第一机构：Chinese Peoples Liberat Army Gen Hosp, Dept Pulm & Crit Care Med, Med Ctr 2, Beijing, Peoples R China

通信机构：[1]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Dept Pulm & Crit Care Med, Med Ctr 2, Beijing, Peoples R China;[2]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing, Peoples R China;[3]corresponding author), Yanan Univ, Med Coll, Yanan, Peoples R China;[4]corresponding author), Capital Med Univ, Beijing Chaoyang Hosp, Dept Pulm & Crit Care Med, Beijing, Peoples R China.

年份：2021

卷号：15

外文期刊名：FRONTIERS IN NEUROSCIENCE

收录：;Scopus(收录号：2-s2.0-85121984552);WOS:【SCI-EXPANDED(收录号:WOS:000738667600001)】；

基金：This study was supported by Military Health Care Project (19BJZ34); Youth Program for Military Medicine of Chinese PLA General Hospital (QNC19054); Open Subject of National Clinical Research Center for Geriatric Diseases (NCRCG-PLAGH-2018008); and Special Project of the Second Medical Center of PLA General Hospital (ZXD2008). The funders had no direct role in the design, data collection, analysis, interpretation, or writing of the manuscript.

语种：英文

外文关键词：Cystatin C; obstructive sleep apnea; elderly; stroke; cohort study

摘要：Background: Few prospective cohort studies have assessed the relationship between Cystatin C (Cys-C) and risk of stroke in elderly patients with obstructive sleep apnea (OSA). The study sought to examine the association between baseline serum Cys-C and long-term risk of stroke among elderly OSA patients.Methods: A total of 932 patients with OSA, no history of stroke, >= 60 years of age, and complete serum Cys-C records were included in this study. All patients had completed polysomnography (PSG). OSA was defined as an apnea-hypopnea index (AHI) of >= 5 events per hour. Participants were categorized into four groups according to baseline serum Cys-C concentration, split into quartiles. Multivariate Cox regression were used to evaluate the association between Cys-C and the incidence of new-onset stroke.Results: Stroke occurred in 61 patients during the median 42-month follow-up period. The cumulative incidence rate of stroke was 6.5%, which included 54 patients with ischemic stroke and 7 patients with hemorrhagic stroke. The cumulative incidence of stroke was higher among patients with baseline serum Cys-C concentration of >= 1.15 mg/L when compared with other groups (PLog-rank < 0.001). After adjusting for potential confounding factors in the Cox regression model, patients with a serum Cys-C concentration of >= 1.15 mg/L had a 2.16-fold higher risk of developing stroke compared with patients with serum Cys-C <= 0.81 mg/L (HR, 2.16, 95%CI, 1.09-6.60; P = 0.017). Additionally, there was a higher risk in those of age >= 70 years (HR, 3.23, 95%CI, 1.05-9.24; P = 0.010). The receiver-operating characteristic curves showed that the capability of Cys-C to identify elderly patients with OSA who had a long-time risk of stroke was moderate (AUC = 0.731, 95% CI: 0.683-0.779, P = 0.001).Conclusion: Increased Cys-C concentration was identified as a risk factor in the incidence of stroke in elderly patients with OSA, independent of gender, BMI, hypertension and other risk factors. Additionally, it conferred a higher risk in patients of age >= 70 years.