{"title":"血清肌酸水平作为烟雾病患者术后脑血管事件的预测因素","authors":"Siqi Mou, Zhikang Zhao, Chenglong Liu, Junsheng Li, Qiheng He, Wei Liu, Bojian Zhang, Zhiyao Zheng, Wei Sun, Xiangjun Shi, Qian Zhang, Rong Wang, Yan Zhang, Peicong Ge, Dong Zhang","doi":"10.1002/brb3.70331","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Creatine is essential for energy storage and transfer within and outside cells. However, its relationship with cerebrovascular disease has not been fully explored. This study examined the association between serum creatine levels and postoperative cerebrovascular events, including transient ischemic attack (TIA), ischemic stroke, and hemorrhagic stroke, in patients with moyamoya disease (MMD).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Serum creatine and disodium creatine phosphate levels were quantified in 352 patients with MMD using liquid chromatography–tandem mass spectrometry. Kaplan–Meier (KM) curves were used to analyze the impact of serum creatine levels on cerebrovascular event risk, whereas univariate and multivariate Cox regression analyses were used to identify predictors of postoperative outcomes. A prognostic nomogram was developed to predict stroke-free survival at 12, 24, and 36 months postoperatively.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In patients with MMD, serum creatine showed a negative correlation with creatinine (<i>r</i> = −0.22; <i>p</i> < 0.001) and homocysteine (<i>r</i> = −0.10; <i>p</i> < 0.05) but not with disodium creatine phosphate (<i>r</i> = −0.08; <i>p</i> = 0.15). When patients were divided into high and low groups based on the median serum creatine concentration, KM curve analysis revealed that patients in the high concentration group had a lower relative risk of cerebrovascular events than those in the low concentration group (hazard ratio: 0.55; 95% confidence interval, 0.33–0.94; <i>p</i> = 0.026). Furthermore, when patients were categorized into three levels based on creatine concentration, the overall KM curve analysis showed a significant difference (<i>p</i> = 0.038), such that the highest creatine concentration group (third tertile) showed a significantly reduced risk compared with the lowest concentration group (first tertile; <i>p</i> = 0.04).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Lower preoperative serum creatine levels were associated with a higher risk of postoperative cerebrovascular events in patients with MMD. Therefore, creatine supplementation may be an effective means of preventing adverse outcomes in patients with MMD.</p>\n </section>\n </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 2","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70331","citationCount":"0","resultStr":"{\"title\":\"Serum Creatine Levels as a Predictive Factor for Postoperative Cerebrovascular Events in Patients With Moyamoya Disease\",\"authors\":\"Siqi Mou, Zhikang Zhao, Chenglong Liu, Junsheng Li, Qiheng He, Wei Liu, Bojian Zhang, Zhiyao Zheng, Wei Sun, Xiangjun Shi, Qian Zhang, Rong Wang, Yan Zhang, Peicong Ge, Dong Zhang\",\"doi\":\"10.1002/brb3.70331\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Creatine is essential for energy storage and transfer within and outside cells. However, its relationship with cerebrovascular disease has not been fully explored. This study examined the association between serum creatine levels and postoperative cerebrovascular events, including transient ischemic attack (TIA), ischemic stroke, and hemorrhagic stroke, in patients with moyamoya disease (MMD).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Serum creatine and disodium creatine phosphate levels were quantified in 352 patients with MMD using liquid chromatography–tandem mass spectrometry. Kaplan–Meier (KM) curves were used to analyze the impact of serum creatine levels on cerebrovascular event risk, whereas univariate and multivariate Cox regression analyses were used to identify predictors of postoperative outcomes. A prognostic nomogram was developed to predict stroke-free survival at 12, 24, and 36 months postoperatively.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In patients with MMD, serum creatine showed a negative correlation with creatinine (<i>r</i> = −0.22; <i>p</i> < 0.001) and homocysteine (<i>r</i> = −0.10; <i>p</i> < 0.05) but not with disodium creatine phosphate (<i>r</i> = −0.08; <i>p</i> = 0.15). When patients were divided into high and low groups based on the median serum creatine concentration, KM curve analysis revealed that patients in the high concentration group had a lower relative risk of cerebrovascular events than those in the low concentration group (hazard ratio: 0.55; 95% confidence interval, 0.33–0.94; <i>p</i> = 0.026). Furthermore, when patients were categorized into three levels based on creatine concentration, the overall KM curve analysis showed a significant difference (<i>p</i> = 0.038), such that the highest creatine concentration group (third tertile) showed a significantly reduced risk compared with the lowest concentration group (first tertile; <i>p</i> = 0.04).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Lower preoperative serum creatine levels were associated with a higher risk of postoperative cerebrovascular events in patients with MMD. Therefore, creatine supplementation may be an effective means of preventing adverse outcomes in patients with MMD.</p>\\n </section>\\n </div>\",\"PeriodicalId\":9081,\"journal\":{\"name\":\"Brain and Behavior\",\"volume\":\"15 2\",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-02-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70331\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brain and Behavior\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/brb3.70331\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"BEHAVIORAL SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain and Behavior","FirstCategoryId":"102","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/brb3.70331","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BEHAVIORAL SCIENCES","Score":null,"Total":0}
Serum Creatine Levels as a Predictive Factor for Postoperative Cerebrovascular Events in Patients With Moyamoya Disease
Background
Creatine is essential for energy storage and transfer within and outside cells. However, its relationship with cerebrovascular disease has not been fully explored. This study examined the association between serum creatine levels and postoperative cerebrovascular events, including transient ischemic attack (TIA), ischemic stroke, and hemorrhagic stroke, in patients with moyamoya disease (MMD).
Methods
Serum creatine and disodium creatine phosphate levels were quantified in 352 patients with MMD using liquid chromatography–tandem mass spectrometry. Kaplan–Meier (KM) curves were used to analyze the impact of serum creatine levels on cerebrovascular event risk, whereas univariate and multivariate Cox regression analyses were used to identify predictors of postoperative outcomes. A prognostic nomogram was developed to predict stroke-free survival at 12, 24, and 36 months postoperatively.
Results
In patients with MMD, serum creatine showed a negative correlation with creatinine (r = −0.22; p < 0.001) and homocysteine (r = −0.10; p < 0.05) but not with disodium creatine phosphate (r = −0.08; p = 0.15). When patients were divided into high and low groups based on the median serum creatine concentration, KM curve analysis revealed that patients in the high concentration group had a lower relative risk of cerebrovascular events than those in the low concentration group (hazard ratio: 0.55; 95% confidence interval, 0.33–0.94; p = 0.026). Furthermore, when patients were categorized into three levels based on creatine concentration, the overall KM curve analysis showed a significant difference (p = 0.038), such that the highest creatine concentration group (third tertile) showed a significantly reduced risk compared with the lowest concentration group (first tertile; p = 0.04).
Conclusion
Lower preoperative serum creatine levels were associated with a higher risk of postoperative cerebrovascular events in patients with MMD. Therefore, creatine supplementation may be an effective means of preventing adverse outcomes in patients with MMD.
期刊介绍:
Brain and Behavior is supported by other journals published by Wiley, including a number of society-owned journals. The journals listed below support Brain and Behavior and participate in the Manuscript Transfer Program by referring articles of suitable quality and offering authors the option to have their paper, with any peer review reports, automatically transferred to Brain and Behavior.
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