Research Progress on the Application of Serum Cystatin C in Patients with Ischemic Stroke
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i4.4815
Abstract
Ischemic stroke, as a chronic noncommunicable disease with high incidence and disability rates, has become a significant global public health issue. Cystatin C, an endogenous biomarker that sensitively reflects glomerular filtration function, has been widely used in recent years for the clinical assessment of cerebrovascular diseases. This study reviews the latest research findings on the correlation between ischemic stroke and serum cystatin C levels from domestic and international sources. It provides an overview of the relationship between the two and their current clinical applications, aiming to offer a reference for disease management and condition monitoring in ischemic stroke patients.
Keywords
ischemic stroke, serum cystatin C, clinical application, research progress
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[3] Gu H Q, Yang X, Wang C J, et al. Clinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China[J]. JAMA Netw Open, 2021,4(8):e2120745.
[4] Wang XiaoJun, Yang KeKe, Wu JianHeng, et al. Analysis and Prediction of Trends in the Disease Burden of Ischemic Stroke Among Young Adults in China [J]. Chinese Journal of Stroke, 2025,20(06):734-745.
[5] Wang Shihong, Lai Fengxia, Zhang Zhiyi, et al. Projected Trends in the Prevalence of Ischemic Stroke in China from 2020 to 2040 [J]. Chinese Journal of Neuroimmunology and Neurology, 2024, 31(06): 459-467.
[6] Kong Weihong, Wu Jinliang, Wang Chaona. Diagnostic Value of Serum Cystatin C and Coagulation Function Indicators in Acute Cerebral Infarction [J]. Systems Medicine, 2025, 10(14): 82-85.
[7] Shlipak M G, Inker L A, Coresh J. Serum Cystatin C for Estimation of GFR[J]. JAMA, 2022,328(9):883-884.
[8] Abrahamson M, Alvarez-Fernandez M, Nathanson C. Cystatins[J]. Biochem Soc Symp, 2003(70):179-199.
[9] Abrahamson M, Olafsson I, Palsdottir A, et al. Structure and expression of the human cystatin C gene[J]. Biochem J, 1990,268(2):287-294.
[10] Onopiuk A, Tokarzewicz A, Gorodkiewicz E. Cystatin C: a kidney function biomarker[J]. Adv Clin Chem, 2015,68:57-69.
[11] Grubb A, Simonsen O, Sturfelt G, et al. Serum concentration of cystatin C, factor D and beta 2-microglobulin as a measure of glomerular filtration rate[J]. Acta Med Scand, 1985,218(5):499-503.
[12] Sawada S. Cystatin C as a Promising Biomarker of Atherosclerotic Plaque[J]. J Atheroscler Thromb, 2021,28(5):474-476.
[13] Stojanovic S D, Fiedler J, Bauersachs J, et al. Senescence-induced inflammation: an important player and key therapeutic target in atherosclerosis[J]. Eur Heart J, 2020,41(31):2983-2996.
[14] Wang J, Luo J, Huang W, et al. Increased intracellular Cl(-) concentration by activating FAK promotes airway epithelial BEAS-2B cells proliferation and wound healing[J]. Arch Biochem Biophys, 2020,680:108225.
[15] Ding L, Liu Z, Wang J. Role of cystatin C in urogenital malignancy[J]. Front Endocrinol (Lausanne), 2022,13:1082871.
[16] Lofberg H, Grubb A O. Quantitation of gamma-trace in human biological fluids: indications for production in the central nervous system[J]. Scand J Clin Lab Invest, 1979,39(7):619-626.
[17] Poulik M D, Perry D J, Vokac E, et al. Post-gamma globulin. II. Radioimmunoassay determination of levels of post-gamma globulin and beta 2-microglobulin[J]. Clin Chim Acta, 1983,128(2-3):249-260.
[18] Shi Mengjing, Zang Yunhua, Li Yuanyuan, et al. Research progress on the relationship between cerebrovascular disease and renal function indicators [J]. Shandong Medicine, 2020, 60(2): 106-108.
[19] Yu Zhijia, Liu Haixuan. Prognostic Value of Serum Homocysteine and Cystine Levels in Elderly Patients with Ischemic Stroke [J]. Journal of North Sichuan Medical College, 2022,37(12):1570-1573.
[20] Bian Yi, Zhou Wensheng, Ji Yongshun, et al. Correlation between Serum ChE, CysC, and NLR Levels with Severity and Prognosis in Acute Cerebral Infarction [J]. Journal of Molecular Diagnosis and Therapy, 2024,16(07):1285-1288.
[21] Shi Yuxi, Ding Hongmei, Geng Deqin. Correlation Analysis of Carotid Plaques with Fibrinogen, Cystatin C, and Oxidized Low-Density Lipoprotein in Patients with Acute Cerebral Infarction [J]. China Medical Guide, 2023, 20(20):101-104.
[22] Wang Jinhua, Duan Tingting, Yang Ming, et al. The predictive value of serum uric acid, alkaline phosphatase, and cystatin C for recurrent ischemic stroke risk [J]. Chinese Journal of Medical Laboratory Science, 2023, 33(13): 1592-1596.
[23] Liu H, Qian S, Zhong C, et al. Predictive Value of Cystatin C for Stroke Recurrence in Patients With Acute Ischemic Stroke[J]. Circ J, 2021,85(2):213-219.
[24] Chen Gai-ping, Wang Guang-shu, Yang Jing, et al. Correlation between Serum Cystatin C, CRP, and LDL Levels and Disease Severity in Patients with Acute Cerebral Infarction: Evaluation of Their Prognostic Value [J]. Chinese Journal of Health Care Medicine, 2023, 25(05): 594-596.
[25] Wang Y, Li W, Yang J, et al. Association Between Cystatin C and the Risk of Ischemic Stroke: a Systematic Review and Meta-analysis[J]. J Mol Neurosci, 2019,69(3):444-449.
[26] Chen Yuxiao, Ding Lidong, Yu Liqiang, et al. Research progress on gut microbiota regulation of inflammatory responses in post-stroke depression [J]. Chinese Journal of Neuroimmunology and Neurology, 2025,32(03):247-252.
[27] Ma Haifeng, Zhai Xiuzhen, Jia Jujuan, et al. Current Status of Post-Stroke Depression in Patients with Ischemic Stroke and Analysis of Related Factors [J]. Chinese Journal of Social Medicine, 2025,42(04):436-439.
[28] Wanggong F, Xiang J, Yang S, et al. Correlation of serum uric acid, cystatin C and high-sensitivity C-reactive protein with cognitive impairment in lacunar cerebral infarction[J]. Am J Transl Res, 2021,13(6):6717-6723.
[29] Xu Qianqian, Qian Xudong, Sun Fan, et al. Relationship between serum cystatin C levels and depressive comorbidity after acute ischemic stroke [J]. Chinese Journal of Modern Medicine, 2023,33(14):64-69.
[30] Fang Zhou, Ye Sheng, Li Weijia, et al. Construction of a Depression Risk Prediction Model After Lacunar Cerebral Infarction [J]. Chinese Journal of Emergency Medicine, 2023,32(10):1390-1396.
[31] Lian Haojun. Development and Validation of a Depression Risk Model Based on Cystatin C Levels After Acute Ischemic Stroke [J]. Medical Clinical Research, 2025,42 (04):608-611.
[32] Song Jing, Li Yufang, Seng Junyan, et al. Correlation Analysis of Serum Homocysteine Levels, Cystatin C Levels, and Depression After Stroke in the Elderly [J]. International Journal of Psychiatry, 2022,49(4):669-671.
[33] Zhang Z, He P, Liu M, et al. Association of Depressive Symptoms with Rapid Kidney Function Decline in Adults with Normal Kidney Function[J]. Clin J Am Soc Nephrol, 2021,16(6):889-897.
[34] Qu Y, Zhuo L, Li N, et al. Prevalence of Post-Stroke Cognitive Impairment in China: A Community-Based, Cross-Sectional Study[J]. PLOS ONE, 2015,10(4): e0122864.
[35] Chinese Society of Stroke, Vascular Cognitive Impairment Branch. Chinese Guidelines for the Diagnosis and Treatment of Vascular Cognitive Impairment (2024 Edition) [J]. Chinese Medical Journal, 2024, 104(31): 2881-2894.
[36] Imarisio A, Pilotto A, Garrafa E, et al. Plasma Cystatin C Correlates with Plasma NfL Levels and Predicts Disease Progression in Parkinson's Disease[J]. Neurodegener Dis, 2021,21(5-6):109-116.
[37] Chen Hongmei. Correlation between Serum Cystatin C Levels and Cognitive Impairment Following Ischemic Stroke [D]. Department of Neurology, Hubei Medical College, 2020.
[38] Hou Yue, Zhao Yan, Wang Youming, et al. Meta-analysis of the correlation between serum cystatin C levels and post-stroke cognitive impairment in stroke patients [J]. Journal of Modern Laboratory Medicine, 2022,37(2):142-147.
[39] Cheng Zhiqing, Zhu Wenzong, Pan Lulu, et al. Relationship between Serum Albumin, Hemoglobin, and Cystatin C Levels and Post-Stroke Cognitive Impairment [J]. Chinese Journal of Medical Laboratory Science, 2023,33(18):2248-2251, 2255.
[40] Zuo L, Dong Y, Pan Y, et al. Impact of Serum Cystatin C Level on Long-Term Cognitive Impairment After Acute Ischemic Stroke and Transient Ischemic Attack[J]. Neuropsychiatr Dis Treat, 2023,19:1543-1554.
[41] Hao C, Chen S. A systematic review and meta-analysis of serum cystatin C levels and acute ischemic stroke outcomes[J]. Adv Clin Exp Med, 2025,34(2):153-163.
[42] Wilson D, Ambler G, Lee K, et al. Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies[J]. Lancet Neurol, 2019,18(7):653-665.
[43] Zhu Xiao-Yu, Zhou Fan-Jing, Xu Yun, et al. Research Progress on the Association Between Microbleed Distribution Patterns and Ischemic Stroke [J]. Chinese Journal of Stroke, 2025, 20(08): 1051-1057.
[44] Gao Qian. Correlation Study of CysC with the Occurrence, Distribution, and Severity of Cerebral Microbleeds in Patients with Ischemic Stroke [D]. Jilin University, 2024.
[45] Li Yinzhen, Zhang Jingwen, Zheng Yongqiang. Application of Serum Hcy, hs-CRP, and CysC Levels in the Occurrence and Prognosis of Cerebral Microbleeds in Patients with Ischemic Stroke [J]. . Chinese Journal of Geriatrics, 2023,43(04):798-802.
[46] Wu Bian, Zheng Jingxia, Liu Wenshuo, et al. Meta-analysis of the correlation between serum cystatin C and cerebral microbleeds in patients with ischemic stroke [J]. Practical Preventive Medicine, 2022,29(06):746-750.
[47] Zhang J, Ju X, Wang J, et al. Serum cystatin C and cerebral microbleeds in patients with acute cerebral stroke[J]. J Clin Neurosci, 2014,21(2):268-273.
[2] Ge R, You S, Zheng D, et al. Global, regional, and national temporal trends of diet-related ischemic stroke mortality and disability from 1990 to 2019[J]. Int J Stroke, 2024:1098970028.
[3] Gu H Q, Yang X, Wang C J, et al. Clinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China[J]. JAMA Netw Open, 2021,4(8):e2120745.
[4] Wang XiaoJun, Yang KeKe, Wu JianHeng, et al. Analysis and Prediction of Trends in the Disease Burden of Ischemic Stroke Among Young Adults in China [J]. Chinese Journal of Stroke, 2025,20(06):734-745.
[5] Wang Shihong, Lai Fengxia, Zhang Zhiyi, et al. Projected Trends in the Prevalence of Ischemic Stroke in China from 2020 to 2040 [J]. Chinese Journal of Neuroimmunology and Neurology, 2024, 31(06): 459-467.
[6] Kong Weihong, Wu Jinliang, Wang Chaona. Diagnostic Value of Serum Cystatin C and Coagulation Function Indicators in Acute Cerebral Infarction [J]. Systems Medicine, 2025, 10(14): 82-85.
[7] Shlipak M G, Inker L A, Coresh J. Serum Cystatin C for Estimation of GFR[J]. JAMA, 2022,328(9):883-884.
[8] Abrahamson M, Alvarez-Fernandez M, Nathanson C. Cystatins[J]. Biochem Soc Symp, 2003(70):179-199.
[9] Abrahamson M, Olafsson I, Palsdottir A, et al. Structure and expression of the human cystatin C gene[J]. Biochem J, 1990,268(2):287-294.
[10] Onopiuk A, Tokarzewicz A, Gorodkiewicz E. Cystatin C: a kidney function biomarker[J]. Adv Clin Chem, 2015,68:57-69.
[11] Grubb A, Simonsen O, Sturfelt G, et al. Serum concentration of cystatin C, factor D and beta 2-microglobulin as a measure of glomerular filtration rate[J]. Acta Med Scand, 1985,218(5):499-503.
[12] Sawada S. Cystatin C as a Promising Biomarker of Atherosclerotic Plaque[J]. J Atheroscler Thromb, 2021,28(5):474-476.
[13] Stojanovic S D, Fiedler J, Bauersachs J, et al. Senescence-induced inflammation: an important player and key therapeutic target in atherosclerosis[J]. Eur Heart J, 2020,41(31):2983-2996.
[14] Wang J, Luo J, Huang W, et al. Increased intracellular Cl(-) concentration by activating FAK promotes airway epithelial BEAS-2B cells proliferation and wound healing[J]. Arch Biochem Biophys, 2020,680:108225.
[15] Ding L, Liu Z, Wang J. Role of cystatin C in urogenital malignancy[J]. Front Endocrinol (Lausanne), 2022,13:1082871.
[16] Lofberg H, Grubb A O. Quantitation of gamma-trace in human biological fluids: indications for production in the central nervous system[J]. Scand J Clin Lab Invest, 1979,39(7):619-626.
[17] Poulik M D, Perry D J, Vokac E, et al. Post-gamma globulin. II. Radioimmunoassay determination of levels of post-gamma globulin and beta 2-microglobulin[J]. Clin Chim Acta, 1983,128(2-3):249-260.
[18] Shi Mengjing, Zang Yunhua, Li Yuanyuan, et al. Research progress on the relationship between cerebrovascular disease and renal function indicators [J]. Shandong Medicine, 2020, 60(2): 106-108.
[19] Yu Zhijia, Liu Haixuan. Prognostic Value of Serum Homocysteine and Cystine Levels in Elderly Patients with Ischemic Stroke [J]. Journal of North Sichuan Medical College, 2022,37(12):1570-1573.
[20] Bian Yi, Zhou Wensheng, Ji Yongshun, et al. Correlation between Serum ChE, CysC, and NLR Levels with Severity and Prognosis in Acute Cerebral Infarction [J]. Journal of Molecular Diagnosis and Therapy, 2024,16(07):1285-1288.
[21] Shi Yuxi, Ding Hongmei, Geng Deqin. Correlation Analysis of Carotid Plaques with Fibrinogen, Cystatin C, and Oxidized Low-Density Lipoprotein in Patients with Acute Cerebral Infarction [J]. China Medical Guide, 2023, 20(20):101-104.
[22] Wang Jinhua, Duan Tingting, Yang Ming, et al. The predictive value of serum uric acid, alkaline phosphatase, and cystatin C for recurrent ischemic stroke risk [J]. Chinese Journal of Medical Laboratory Science, 2023, 33(13): 1592-1596.
[23] Liu H, Qian S, Zhong C, et al. Predictive Value of Cystatin C for Stroke Recurrence in Patients With Acute Ischemic Stroke[J]. Circ J, 2021,85(2):213-219.
[24] Chen Gai-ping, Wang Guang-shu, Yang Jing, et al. Correlation between Serum Cystatin C, CRP, and LDL Levels and Disease Severity in Patients with Acute Cerebral Infarction: Evaluation of Their Prognostic Value [J]. Chinese Journal of Health Care Medicine, 2023, 25(05): 594-596.
[25] Wang Y, Li W, Yang J, et al. Association Between Cystatin C and the Risk of Ischemic Stroke: a Systematic Review and Meta-analysis[J]. J Mol Neurosci, 2019,69(3):444-449.
[26] Chen Yuxiao, Ding Lidong, Yu Liqiang, et al. Research progress on gut microbiota regulation of inflammatory responses in post-stroke depression [J]. Chinese Journal of Neuroimmunology and Neurology, 2025,32(03):247-252.
[27] Ma Haifeng, Zhai Xiuzhen, Jia Jujuan, et al. Current Status of Post-Stroke Depression in Patients with Ischemic Stroke and Analysis of Related Factors [J]. Chinese Journal of Social Medicine, 2025,42(04):436-439.
[28] Wanggong F, Xiang J, Yang S, et al. Correlation of serum uric acid, cystatin C and high-sensitivity C-reactive protein with cognitive impairment in lacunar cerebral infarction[J]. Am J Transl Res, 2021,13(6):6717-6723.
[29] Xu Qianqian, Qian Xudong, Sun Fan, et al. Relationship between serum cystatin C levels and depressive comorbidity after acute ischemic stroke [J]. Chinese Journal of Modern Medicine, 2023,33(14):64-69.
[30] Fang Zhou, Ye Sheng, Li Weijia, et al. Construction of a Depression Risk Prediction Model After Lacunar Cerebral Infarction [J]. Chinese Journal of Emergency Medicine, 2023,32(10):1390-1396.
[31] Lian Haojun. Development and Validation of a Depression Risk Model Based on Cystatin C Levels After Acute Ischemic Stroke [J]. Medical Clinical Research, 2025,42 (04):608-611.
[32] Song Jing, Li Yufang, Seng Junyan, et al. Correlation Analysis of Serum Homocysteine Levels, Cystatin C Levels, and Depression After Stroke in the Elderly [J]. International Journal of Psychiatry, 2022,49(4):669-671.
[33] Zhang Z, He P, Liu M, et al. Association of Depressive Symptoms with Rapid Kidney Function Decline in Adults with Normal Kidney Function[J]. Clin J Am Soc Nephrol, 2021,16(6):889-897.
[34] Qu Y, Zhuo L, Li N, et al. Prevalence of Post-Stroke Cognitive Impairment in China: A Community-Based, Cross-Sectional Study[J]. PLOS ONE, 2015,10(4): e0122864.
[35] Chinese Society of Stroke, Vascular Cognitive Impairment Branch. Chinese Guidelines for the Diagnosis and Treatment of Vascular Cognitive Impairment (2024 Edition) [J]. Chinese Medical Journal, 2024, 104(31): 2881-2894.
[36] Imarisio A, Pilotto A, Garrafa E, et al. Plasma Cystatin C Correlates with Plasma NfL Levels and Predicts Disease Progression in Parkinson's Disease[J]. Neurodegener Dis, 2021,21(5-6):109-116.
[37] Chen Hongmei. Correlation between Serum Cystatin C Levels and Cognitive Impairment Following Ischemic Stroke [D]. Department of Neurology, Hubei Medical College, 2020.
[38] Hou Yue, Zhao Yan, Wang Youming, et al. Meta-analysis of the correlation between serum cystatin C levels and post-stroke cognitive impairment in stroke patients [J]. Journal of Modern Laboratory Medicine, 2022,37(2):142-147.
[39] Cheng Zhiqing, Zhu Wenzong, Pan Lulu, et al. Relationship between Serum Albumin, Hemoglobin, and Cystatin C Levels and Post-Stroke Cognitive Impairment [J]. Chinese Journal of Medical Laboratory Science, 2023,33(18):2248-2251, 2255.
[40] Zuo L, Dong Y, Pan Y, et al. Impact of Serum Cystatin C Level on Long-Term Cognitive Impairment After Acute Ischemic Stroke and Transient Ischemic Attack[J]. Neuropsychiatr Dis Treat, 2023,19:1543-1554.
[41] Hao C, Chen S. A systematic review and meta-analysis of serum cystatin C levels and acute ischemic stroke outcomes[J]. Adv Clin Exp Med, 2025,34(2):153-163.
[42] Wilson D, Ambler G, Lee K, et al. Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies[J]. Lancet Neurol, 2019,18(7):653-665.
[43] Zhu Xiao-Yu, Zhou Fan-Jing, Xu Yun, et al. Research Progress on the Association Between Microbleed Distribution Patterns and Ischemic Stroke [J]. Chinese Journal of Stroke, 2025, 20(08): 1051-1057.
[44] Gao Qian. Correlation Study of CysC with the Occurrence, Distribution, and Severity of Cerebral Microbleeds in Patients with Ischemic Stroke [D]. Jilin University, 2024.
[45] Li Yinzhen, Zhang Jingwen, Zheng Yongqiang. Application of Serum Hcy, hs-CRP, and CysC Levels in the Occurrence and Prognosis of Cerebral Microbleeds in Patients with Ischemic Stroke [J]. . Chinese Journal of Geriatrics, 2023,43(04):798-802.
[46] Wu Bian, Zheng Jingxia, Liu Wenshuo, et al. Meta-analysis of the correlation between serum cystatin C and cerebral microbleeds in patients with ischemic stroke [J]. Practical Preventive Medicine, 2022,29(06):746-750.
[47] Zhang J, Ju X, Wang J, et al. Serum cystatin C and cerebral microbleeds in patients with acute cerebral stroke[J]. J Clin Neurosci, 2014,21(2):268-273.
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