Homocysteine, cystatin C and N-terminal-pro brain natriuretic Peptide. Vascular risk markers in elderly patients with mental illness.
BACKGROUND
There is increasing evidence that vascular disease contributes to cognitive impairment and dementia. Clarification of the role of vascular risk factors in dementia is important because most are modifiable, in contrast to other risk factors such as age and genetics.


METHODS
In 451 patients with mental illness we have investigated three biochemical markers related to vascular disease, total plasma homocysteine (tHcy), cystatin C, and N-terminal-pro brain natriuretic peptide (NT-proBNP), and their association with vascular disease, diagnoses, and brain imaging findings (CT).


RESULTS
Plasma tHcy, serum cystatin C, and serum NT-proBNP showed significantly increased frequencies of elevated levels in patients with vascular disease, in patients with a pathological CT finding indicating cerebrovascular disease, and in patients above 75 years of age.


CONCLUSIONS
It is possible that the control of conventional vascular risk factors and therapy could be guided by the level of plasma tHcy, serum cystatin C, and serum NT-proBNP. Patients with an elevation of any of these three parameters could be selected for a lower target level of risk factors such as blood pressure, hyperlipidemia etc. than conventional target levels.
Department of Psychogeriatrics, Clinical Science Lund University Hospital, Lund, Sweden.
Karin
K
Nilsson
Lars
L
Gustafson
Björn
B
Hultberg
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging; D055316:Cystatin C; D015891:Cystatins / Q000097:blood*; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology*
C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain