Increased Serum Cystatin C in Early Parkinson's Disease with Objective Sleep Disturbances

Abstract

Background:Sleep disturbance is one of the major non-motor symptoms which cause the disability of Parkinson's disease (PD) patients. Cystatin C (CysC) is a more sensitive biomarker than serum creatinine or estimated glomerular filtration rate. Previous studies have reported altered CysC levels in neurodegenerative disorders and sleep disorders. This study aimed to explore the correlations of serum CysC levels and objective sleep disturbances in early PD.Methods:We recruited 106 early PD patients and 146 age- and sex-matched controls. All participants underwent clinical investigation and video-polysomnography. Sleep parameters and serum levels of CysC were measured. Then, we investigated the relationships between CysC and clinical variables and objective sleep disturbances in early PD patients.Results:The mean serum level of CysC was significantly higher in patients with early PD (1.03 ± 0.19 mg/L) compared to controls (0.96 ± 0.15 mg/L, P = 0.009). There were significantly positive correlations between serum CysC levels and age (r = 0.334, P < 0.001), gender (r = 0.264, P = 0.013), and creatinine levels (r = 0.302, P = 0.018) in early PD patients. Increased serum CysC levels in early PD patients were significantly associated with higher apnea and hypopnea index (AHI) (r = 0.231, P = 0.017), especially hypopnea index (r = 0.333, P < 0.001). In early PD patients, elevated serum CysC levels were positively correlated with oxygen desaturation index (r = 0.223, P = 0.021), percentage of time spent at oxygen saturation (SaO2) <90% (r = 0.644, P < 0.001), arousal with respiratory event during sleep (r = 0.247, P = 0.013). On the contrary, the elevated serum CysC levels were negatively correlated with mean and minimal SaO2 (r = −0.323, −0.315, both P = 0.001) in PD patients.Conclusions:The level of serum CysC was higher in early PD patients. PD patients with elevated serum CysC levels had more respiratory events and more severe oxygen desaturation. Therefore, the serum CysC levels may predict the severities of sleep-disordered breathing problems in early PD patients.

Plasma Cystatin C Correlates with Plasma NfL Levels and Predicts Disease Progression in Parkinson’s Disease

“…In addition, the present work provides the first evidence of a significant correlation between plasma levels of Cys-C and NfL, a well-known marker of axonal damage in neurodegenerative diseases [7,8,27,28]. According to previous cross-sectional reports, we found increased plasma levels of Cys-C in PD compared to HC [18,19,[29][30][31] (online suppl. Table 2).…”

“…According to previous cross-sectional reports, we found increased plasma levels of Cys-C in PD compared to HC [18, 19, 29-31] (online suppl. Table 2).…”

Recent Evidence in Epigenomics and Proteomics Biomarkers for Early and Minimally Invasive Diagnosis of Alzheimer’s and Parkinson’s Diseases

“…The second group of analytical tools used for protein targeted determinations is based on western blot [ 166 - 170 ]. In addition, few of them used immunoturbidimetric, chemiluminiscent methods [ 171 - 174 ], or flow cytometry [ 175 ].…”

“…Caffeine metabolites, which have neuroprotective effects, were also differentially expressed in early PD [ 252 ]. In addition, Cystatin C was able to predict the severity of sleep-disordered breathing associated with PD [ 171 ]. Tumor necrosis factor-α-induced protein-8 like-2 (TIPE2) has been postulated as a good prognosis biomarker [ 238 ].…”

On the correlation between serum Cystatin C and Parkinson’s disease in the Chinese population: a promising biomarker?

“…Screened as per strict inclusion criteria [14][15][16][20][21][22][23][24][25][26][27][28][29][30][31][32], a total of 16 articles were included, containing 1764 patients with PD. The detailed literature screening process was shown in Fig.…”