胱抑素C水平与我国中老年人帕金森病发病风险关系的纵向队列研究

Objective To investigate the relationship between serum cystatin C (CysC) level and the risk of Parkinson's disease (PD) in middle-aged and elderly people in China. Methods Based on the baseline survey data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, participants who were not diagnosed with PD at the time of the baseline survey were recruited. The onset of PD was tracked and followed up until 2020, and the participants were divided into PD group and non-PD group according to whether they were newly diagnosed with PD in 2020. Multivariable Logistic regression analysis was performed to assess the association between serum CysC level and the risk of PD. Subgroup and interaction analyses were performed to assess effect modifications by age, gender and depression. Additionally, restricted cubic spline (RCS) was used to explore the linear or non-linear relationship between serum CysC level and the risk of PD in different subgroups. Results We included a total of 3 339 subjects in this study, who consisted of 1 495 males (44.77%) and 1 844 females (55.23%). While baseline participants were followed until 2020, 32 subjects had a new PD, and the incidence of PD was 0.96%. The median age of PD group was 63.00 years. Multivariable Logistic regression analysis found that CysC was an independent risk factor for the risk of PD, and CysC was positive significantly associated with the risk of PD (OR = 2.34, 95% CI: 1 .14 - 4.82, P = 0.021). Subgroup analysis showed that CysC was positively associated with PD in females (OR = 2.70, 95% CI: 1.30-5.58, P = 0.007) and subjects aged 60 years or older ( OR =5.29, 95% CI: 1.69-16.53, P = 0.004). RCS model indicated a linear relationship between serum CysC level and the risk of PD in females (P_total= 0.018, P_non-linear= 0.062) and subjects aged 60 years or older (P_total= 0.024, P_non-linear = 0.379). Conclusion High level of CysC may increase the risk of PD in middle-aged and elderly people, especially in females and those aged 60 years or older.