Abstract
Objectives: Cystatin C (Cys C) and high-density lipoprotein (HDL) play critical roles in neurodegenerative diseases, such as dementia, Alzheimer’s disease (AD) and vascular dementia (VaD). However, whether they can be used as reliable biomarkers to distinguish patients with dementia from healthy subjects and to determine disease severity remain largely unknown.Methods: We conducted a cross-sectional study to determine plasma Cys C and HDL levels of 88 patients with dementia (43 AD patients, 45 VaD patients) and 45 healthy age-matched controls. The severity of dementia was determined based on the Schwab and England Activities of Daily Living (ADL) Scale, the Mini-mental State Examination (MMSE), the Global Deterioration Scale (GDS), the Lawton Instrumental ADL (IADL) Scale, and the Hachinski Ischemia Scale (Hachinski). Receiver operating characteristic (ROC) curves were calculated to determine the diagnostic accuracy of Cys C and HDL levels in distinguishing patients with dementia from healthy subjects.Results: We found that plasma Cys C levels were higher, but HDL levels were lower in AD and VaD patients respectively, compared to healthy control subjects. Yet, Cys C levels were highest among patients with VaD. Interestingly, plasma Cys C levels were significantly correlated with IADL Scale scores. In addition, the ROC curves for Cys C (area under the curve, AUC 0.816 for AD, AUC 0.841 for VaD) and HDL (AUC 0.800 for AD, AUC 0.731 for VaD) exhibited potential diagnostic value in distinguishing AD/VaD patients from healthy subjects. While the ROC curve for the combination of Cys C and HDL (AUC 0.873 for AD, AUC 0.897 for VaD) showed higher diagnostic accuracy in distinguishing AD/VaD patients from healthy subjects than the separate curves for each parameter.Conclusions: Our findings suggest that the inflammatory mediators Cys C and HDL may play important roles in the pathogenesis of dementia, and plasma Cys C and HDL levels may be useful screening tools for differentiating AD/VaD patients from healthy subjects.HighlightsPlasma Cys C levels were higher in patients with AD/VaD than in healthy subjects.Plasma HDL levels were lower in patients with AD/VaD than in healthy subjects.Plasma Cys C levels were significantly correlated with dementia.The ROC curve for the combination of Cys C and HDL showed potential diagnostic value in distinguishing AD/VaD from healthy subjects.
Highlights
Dementia represents a broad category of brain diseases that usually cause declines in memory and gradual decreases in cognition that affect a person’s quality of life (Paulsen et al, 2013)
We found that plasma Cystatin C (Cys C) levels were higher, but high-density lipoprotein (HDL) levels were lower in Alzheimer’s disease (AD) and vascular dementia (VaD) patients respectively, compared to healthy control subjects
Plasma Cys C levels were significantly correlated with Instrumental ADL (IADL) Scale scores
Summary
Dementia represents a broad category of brain diseases that usually cause declines in memory and gradual decreases in cognition that affect a person’s quality of life (Paulsen et al, 2013). Common types of dementia include Alzheimer’s disease (AD), vascular dementia (VaD), Lewy body dementia (LBD), frontotemporal dementia (FTD), multiple system atrophy dementia (MSA-D) and Parkinson’s disease dementia (PDD). AD and VaD are the most common types (PosadaDuque et al, 2014; Xu et al, 2014). AD is characterized by the accumulation of amyloid-β (Aβ) peptides and Tau (Kandimalla et al, 2011, 2014; Bourdenx et al, 2015; Hoppe et al, 2015). VaD is characterized by the occurrence of minor strokes and the development of cognitive deficits (Ray et al, 2013). It is hard to differentiate from each other only based on the clinical features (Ray et al, 2013)
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