Cystatin C and Glucose Homeostasis in Cognitive Decline

Published on March 28, 2023

Think of the brain as a sprawling city that needs a steady supply of electricity to stay running smoothly. Well, in this study, scientists looked at how glucose homeostasis, or the proper balance of sugar in the body, interacts with cystatin C, a protein that can affect brain function. They found that elevated levels of cystatin C were linked to an increased risk of mild cognitive impairment (MCI), which is like a blackout in the city. But here’s the twist: the researchers discovered that one particular glucose homeostasis indicator, HOMA-β, acted as a negative mediator, somewhat like a backup generator that helps prevent blackouts. It seems that the higher the levels of HOMA-β, the lower the risk of MCI. The researchers also found that these associations were only observed in participants with diabetes. So, it’s like having extra safeguards against power outages, but only if you have a faulty power grid to begin with. Fascinating, right? If you want to dive deeper into this study and learn more about how glucose and cystatin C dance together in the brain, be sure to check out the link below!

BackgroundThis study explored the mediating role of glucose homeostasis indicators in the relationship between serum cystatin C and mild cognitive impairment (MCI).MethodsThe present study used a cross-sectional design and included 514 participants aged ≥50 years in Beijing, China. The Mini-Mental State Examination was used to assess cognitive function. Serum cystatin C and a comprehensive set of glucose homeostasis indicators were detected, including fasting blood glucose (FBG), glycosylated albumin percentage (GAP), glycated hemoglobin (HbAlc), insulin, and homeostatic model assessment of insulin resistance (HOMA-IR), and beta cell function (HOMA-β). Generalized linear models were used to investigate the associations among cystatin C, glucose homeostasis indicators, and cognitive function. Mediation analysis was conducted to explore potential mediator variables.ResultsIn this study of 514 participants, 76 (14.8%) had MCI. Those with cystatin C levels ≥1.09 mg/L had a 1.98-fold higher risk of MCI than those with levels <1.09 mg/L (95% CI, 1.05–3.69). FBG, GAP, and HbA1c increased the risk of MCI, while HOMA-β decreased the risk. Notably, the associations between MCI risk and cystatin C or glucose homeostasis were only founded in diabetes patients. Serum cystatin C was found to be positively associated with HOMA-β (beta (95% CI): 0.20 [0.06, 0.34]), HOMA-IR (0.23 [0.09, 0.36]), and insulin (0.22 [0.09, 0.34]) levels. Moreover, HOMA-β was identified as playing a negative mediating role (proportion mediated: −16%) in the relationship between cystatin C and MCI.ConclusionElevated levels of cystatin C are associated with an increased risk of MCI. The glucose homeostasis indicator, HOMA-β, plays a negative mediating role in the relationship between cystatin C and MCI risk.

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