Association of Differences in Cystatin C‐ and Creatinine‐Based Estimated Glomerular Filtration Rate With Prevalence and Incidence of Stroke

Background The intraindividual difference between the estimated glomerular filtration rates by cystatin C and creatinine (ie, eGFRdiff) is of clinical importance. This study aimed to investigate the cross‐sectional and longitudinal associations of eGFRdiff with stroke using nationally representative...

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Main Authors: Xiaohua Shi, Jiayin Song, Fenglin Chen, Lingyu Zhang, Yuanmei Chen, Wanqi Xu, Chen Sheng, Zhiyuan Wu, Zhongxin Xu, Cancan Cui
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.039185
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author Xiaohua Shi
Jiayin Song
Fenglin Chen
Lingyu Zhang
Yuanmei Chen
Wanqi Xu
Chen Sheng
Zhiyuan Wu
Zhongxin Xu
Cancan Cui
author_facet Xiaohua Shi
Jiayin Song
Fenglin Chen
Lingyu Zhang
Yuanmei Chen
Wanqi Xu
Chen Sheng
Zhiyuan Wu
Zhongxin Xu
Cancan Cui
author_sort Xiaohua Shi
collection DOAJ
description Background The intraindividual difference between the estimated glomerular filtration rates by cystatin C and creatinine (ie, eGFRdiff) is of clinical importance. This study aimed to investigate the cross‐sectional and longitudinal associations of eGFRdiff with stroke using nationally representative data from the CHARLS (China Health and Retirement Longitudinal Study). Methods This study included 11 869 participants (aged ≥45 years) from the CHARLS 2015 for the cross‐sectional analysis. A total of 11 553 participants free of stroke were recruited in 2015 as baseline and followed up to 2020 for the cohort analysis. The eGFRdiff was calculated by subtracting estimated glomerular filtration rate by serum creatinine from estimated glomerular filtration rate by serum cystatin C at baseline. Logistic regression models and Cox proportional hazards models were used to examine the cross‐sectional and longitudinal associations. Results The mean age of the participants was 60.3±9.6 years, and 5514 (46.5%) were men. According to the cross‐sectional analysis, a negative eGFRdiff was associated with a greater prevalence of stroke (odds ratio per 1 SD, 0.841 [95% CI, 0.741–0.955]). During a median follow‐up of 5.0 years, 838 individuals (7.3%) experienced incident stroke. A lower baseline eGFRdiff was associated with a greater risk of stroke onset (hazard ratio [HR] per 1 SD, 0.884 [95% CI, 0.817–0.955]). Compared with those in the midrange eGFRdiff group (from −15 to 15 mL/min per 1.73 m2), those in the negative eGFRdiff group (<−15 mL/min per 1.73 m2) exhibited a significantly increased risk of incident stroke (HR, 1.202 [95% CI, 1.026–1.407]). Conclusions A large negative eGFRdiff was independently associated with higher prevalence and incidence rates of stroke among middle‐aged and older Chinese adults.
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spelling doaj-art-5b564f5a945a46ccb740fdba9fea69ff2025-08-20T02:37:25ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-06-01141110.1161/JAHA.124.039185Association of Differences in Cystatin C‐ and Creatinine‐Based Estimated Glomerular Filtration Rate With Prevalence and Incidence of StrokeXiaohua Shi0Jiayin Song1Fenglin Chen2Lingyu Zhang3Yuanmei Chen4Wanqi Xu5Chen Sheng6Zhiyuan Wu7Zhongxin Xu8Cancan Cui9Department of Neurology, China‐Japan Union Hospital of Jilin University Jilin University Jilin ChinaDepartment of Radiology, China‐Japan Union Hospital of Jilin University Jilin University Jilin ChinaDepartment of Neurology, China‐Japan Union Hospital of Jilin University Jilin University Jilin ChinaDepartment of Endocrinology Changchun University of Chinese Medicine Jilin ChinaDepartment of Neurology, China‐Japan Union Hospital of Jilin University Jilin University Jilin ChinaDepartment of Chinese Language and Literature, College of Literature and Communication Qingdao University Shandong ChinaDepartment of Epidemiology Boston University School of Public Health Boston MA USADepartment of Nutrition Harvard T H Chan School of Public Health Boston MA USADepartment of Neurology, China‐Japan Union Hospital of Jilin University Jilin University Jilin ChinaDepartment of Radiology, China‐Japan Union Hospital of Jilin University Jilin University Jilin ChinaBackground The intraindividual difference between the estimated glomerular filtration rates by cystatin C and creatinine (ie, eGFRdiff) is of clinical importance. This study aimed to investigate the cross‐sectional and longitudinal associations of eGFRdiff with stroke using nationally representative data from the CHARLS (China Health and Retirement Longitudinal Study). Methods This study included 11 869 participants (aged ≥45 years) from the CHARLS 2015 for the cross‐sectional analysis. A total of 11 553 participants free of stroke were recruited in 2015 as baseline and followed up to 2020 for the cohort analysis. The eGFRdiff was calculated by subtracting estimated glomerular filtration rate by serum creatinine from estimated glomerular filtration rate by serum cystatin C at baseline. Logistic regression models and Cox proportional hazards models were used to examine the cross‐sectional and longitudinal associations. Results The mean age of the participants was 60.3±9.6 years, and 5514 (46.5%) were men. According to the cross‐sectional analysis, a negative eGFRdiff was associated with a greater prevalence of stroke (odds ratio per 1 SD, 0.841 [95% CI, 0.741–0.955]). During a median follow‐up of 5.0 years, 838 individuals (7.3%) experienced incident stroke. A lower baseline eGFRdiff was associated with a greater risk of stroke onset (hazard ratio [HR] per 1 SD, 0.884 [95% CI, 0.817–0.955]). Compared with those in the midrange eGFRdiff group (from −15 to 15 mL/min per 1.73 m2), those in the negative eGFRdiff group (<−15 mL/min per 1.73 m2) exhibited a significantly increased risk of incident stroke (HR, 1.202 [95% CI, 1.026–1.407]). Conclusions A large negative eGFRdiff was independently associated with higher prevalence and incidence rates of stroke among middle‐aged and older Chinese adults.https://www.ahajournals.org/doi/10.1161/JAHA.124.039185creatininecystatin CeGFRdiffestimated glomerular filtration ratestroke
spellingShingle Xiaohua Shi
Jiayin Song
Fenglin Chen
Lingyu Zhang
Yuanmei Chen
Wanqi Xu
Chen Sheng
Zhiyuan Wu
Zhongxin Xu
Cancan Cui
Association of Differences in Cystatin C‐ and Creatinine‐Based Estimated Glomerular Filtration Rate With Prevalence and Incidence of Stroke
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
creatinine
cystatin C
eGFRdiff
estimated glomerular filtration rate
stroke
title Association of Differences in Cystatin C‐ and Creatinine‐Based Estimated Glomerular Filtration Rate With Prevalence and Incidence of Stroke
title_full Association of Differences in Cystatin C‐ and Creatinine‐Based Estimated Glomerular Filtration Rate With Prevalence and Incidence of Stroke
title_fullStr Association of Differences in Cystatin C‐ and Creatinine‐Based Estimated Glomerular Filtration Rate With Prevalence and Incidence of Stroke
title_full_unstemmed Association of Differences in Cystatin C‐ and Creatinine‐Based Estimated Glomerular Filtration Rate With Prevalence and Incidence of Stroke
title_short Association of Differences in Cystatin C‐ and Creatinine‐Based Estimated Glomerular Filtration Rate With Prevalence and Incidence of Stroke
title_sort association of differences in cystatin c and creatinine based estimated glomerular filtration rate with prevalence and incidence of stroke
topic creatinine
cystatin C
eGFRdiff
estimated glomerular filtration rate
stroke
url https://www.ahajournals.org/doi/10.1161/JAHA.124.039185
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