ArticleFrontiers in medicine2026
Long-term cystatin C trajectories and cognitive decline in diabetes and non-diabetes: evidence from a national Chinese cohort.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The relationship between Cystatin C levels and cognitive function remains unclear. This study aims to investigate the association between cumulative changes and trajectory patterns of Cystatin C and cognitive decline in diabetes and non-diabetes using a nationally representative cohort. Methods: A total of 3,733 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included. Cumulative exposure was assessed based on repeated measurements from the first and third waves. K-means clustering was used to classify the longitudinal changes of Cystatin C. The long-term effects of Cystatin C on cognitive decline were evaluated, and subgroup analyses were performed in different populations. The mediating roles of glucose and HDL were also analyzed. Results: During the 3-year follow-up, cognitive decline occurred in 20.4% of the participants. In the non-DM (non-diabetes mellitus) group, cumulative Cystatin C increased the risk of cognitive decline. Compared with maintaining a medium level, maintaining a low level of Cystatin C was associated with a decreased risk of cognitive impairment. Subgroup analysis results showed that, in individuals with diabetes and aged ≥65 years, maintaining a low level of Cystatin C was associated with an increased risk of cognitive decline compared with maintaining a medium level. In non-diabetic individuals aged ≥65 years, cumulative Cystatin C increased the risk of cognitive decline. In non-diabetic and non-hypertensive individuals, maintaining a low level of Cystatin C was associated with a decreased risk of cognitive decline compared with maintaining a medium level. Conclusion: This study found that maintaining a low level of Cystatin C is associated with a lower risk of cognitive decline in non-diabetic individuals, while in older individuals with diabetes, maintaining a low level of Cystatin C increases the risk of cognitive decline. These findings suggest that the long-term dynamic changes in Cystatin C can serve as a useful indicator for assessing the risk of cognitive decline and highlight the need for differentiated preventive strategies in different populations.
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