To investigate the association of serum cystatin C and homocysteine with leukoaraiosis in the elderly population to find reliable biomarkers.

Electronic medical records of 130 elderly patients admitted to the Department of Geratology of the First Affiliated Hospital, College of Medicine, Zhejiang University from November 2016 to September 2017 were collected. The general data (including age, gender, hypertension, and course of hypertension) and biochemical indicators (including triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, uric acid, cystatin C, and homocysteine) of all patients were recorded. Those 130 elderly patients were divided into a normal group (n = 31), a mildly abnormal group (n = 26), a moderately abnormal group (n = 32) and a severely abnormal group (n = 41) by a semi-quantitative method. The correlation among age, course of hypertension, uric acid, cystatin C, and homocysteine with the severity of leukoaraiosis was analyzed by Spearman correlation. Then age, course of hypertension, uric acid, cystatin C, and homocysteine were included in a Logistic multivariate regression model to analyze related factors affecting the severity of leukoaraiosis.

Age [(73 ± 6), (72 ± 7), (76 ± 6), (79 ± 7) years, F = 10.487, P < 0.001], course of hypertension [0 (0, 2), 4 (0, 16), 2 (0, 15), 10 (0, 15) years, H = 10.711, P = 0.013], uric acid [(274 ± 74), (294 ± 67), (315 ± 64), (343 ± 120) μmol/L, F = 3.964, P = 0.010], cystatin C [(0.96 ± 0.29), (1.24 ± 0.32), (1.42 ± 0.40), (1.84 ± 0.65) mg/L, F = 23.025, P = 0.001], and homocysteine [(10.1 ± 2.3), (11.4 ± 2.9), (12.5 ± 2.7), (18.0 ± 3.5) μmol/L, F = 39.271, P < 0.001] of elderly patients in normal, mildly abnormal, moderately abnormal and severely abnormal groups were statistically significantly different. In further pairwise comparisons, the age of patients in the severely abnormal group was significantly higher than that in normal, mildly abnormal and moderately abnormal groups (all P < 0.05), and the course of hypertension in mildly and severely abnormal groups was significantly longer than that in the normal group (both P < 0.05). The level of cystatin C in the mildly abnormal group was significantly higher than that in the normal group (P < 0.05). The levels of cystatin C and homocysteine were significantly higher in the moderately abnormal group than in the normal group (both P < 0.05) and those indicators were significantly higher in the severely abnormal group than in normal, mildly abnormal and moderately abnormal groups (all P < 0.05). Meanwhile, the uric acid level in the severely abnormal group was significantly higher than that in normal and mildly abnormal groups (both P < 0.05). Correlation analysis showed that age (r = 0.406, P < 0.001), course of hypertension (r = 0.263, P = 0.002), uric acid (r = 0.293, P = 0.001), cystatin C (r = 0.588, P < 0.001), and homocysteine (r = 0.646, P < 0.001) were associated with leukoaraiosis. Logistic regression analysis showed that age [odds ratio (OR) = 1.099, 95% confidence interval (CI) (1.030, 1.168), P = 0.003], cystatin C [OR = 11.345, 95%CI (3.725, 34.549), P < 0.001], and homocysteine [OR = 1.438, 95%CI (1.262, 1.638), P < 0.001] were related factors affecting the severity of leukoaraiosis.

Serum cystatin C and homocysteine may be risk factors for leukoaraiosis in elderly patients, which can be used to preliminarily evaluate its severity.