Abstract | BACKGROUND: Multiple lines of research suggest that increased cystatin C activity in the brain protects against the development of Alzheimer disease (AD). METHODS: Serum cystatin C levels were analyzed at two examinations of the Uppsala Longitudinal Study of Adult Men, a longitudinal, community-based study of elderly men (age 70 years, n = 1,153 and age 77 years, n = 761, a subset of the age 70 examination). Cox regressions were used to examine associations between serum cystatin C and incident AD. AD cases were identified by cognitive screening and comprehensive medical chart review in all subjects. RESULTS: On follow-up (median 11.3 years), 82 subjects developed AD. At age 70 years, lower cystatin C was associated with higher risk of AD independently of age, APOE4 genotype, glomerular filtration rate, diabetes, hypertension, stroke, cholesterol, body mass index, smoking, education level, and plasma amyloid-beta protein 40 and 42 levels (hazard ratio [HR] for lowest [<1.12 micromol/L] vs highest [>1.30 micromol/L] tertile = 2.67, 95% CI 1.22-5.83, p < 0.02). The results were similar at age 77 years (43 participants developed AD during follow-up). Furthermore, a 0.1-mumol/L decrease of cystatin C between ages 70 and 77 years was associated with a 29% higher risk of incident AD (HR 1.29, 95% CI 1.03-1.63, p < 0.03). CONCLUSIONS: Low levels of serum cystatin C precede clinically manifest Alzheimer disease (AD) in elderly men free of dementia at baseline and may be a marker of future risk of AD. These findings strengthen the evidence for a role for cystatin C in the development of clinical AD.
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Authors | J Sundelöf, J Arnlöv, E Ingelsson, J Sundström, S Basu, B Zethelius, A Larsson, M C Irizarry, V Giedraitis, E Rönnemaa, M Degerman-Gunnarsson, B T Hyman, H Basun, L Kilander, L Lannfelt |
Journal | Neurology
(Neurology)
Vol. 71
Issue 14
Pg. 1072-9
(Sep 30 2008)
ISSN: 1526-632X [Electronic] United States |
PMID | 18824671
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- CST3 protein, human
- Cystatin C
- Cystatins
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Topics |
- Aged
- Aging
(blood)
- Alzheimer Disease
(blood, epidemiology, physiopathology)
- Biomarkers
(analysis, blood)
- Brain
(metabolism, physiopathology)
- Causality
- Cohort Studies
- Cystatin C
- Cystatins
(analysis, blood)
- Cytoprotection
(physiology)
- Down-Regulation
(physiology)
- Humans
- Hyperlipidemias
(epidemiology)
- Kidney Diseases
(epidemiology)
- Longitudinal Studies
- Male
- Obesity
(epidemiology)
- Predictive Value of Tests
- Proportional Hazards Models
- Risk Factors
- Smoking
(epidemiology)
- Sweden
(epidemiology)
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