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Objective:To investigate the correlation between serum cystatin C (CysC) and clinical and pathological features of IgA nephropathy.Methods:Four hundred and twenty-one cases of primary IgA nephropathy diagnosed by renal biopsy in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2010 to January 2021 were retrospectively analyzed. According to the serum CysC level at the time of renal biopsy, the patients were divided into high serum CysC group and normal serum CysC group, and the clinical data and pathological indices of the patients were compared. Spearman correlation analysis was used to analyze the correlation between estimated glomerular filtration rate (eGFR) and serum CysC. The clinicopathological factors related to the serum CysC level were analyzed by multiple linear regression. The area under the receiver operator characteristic curve (AUC) was used to evaluate the ability of serum CysC level to predict related pathological injury.Results:The age, prevalence of hypertension, serum creatinine, urea and uric acid levels of high serum CysC group were significantly higher than those of normal serum CysC group, while the eGFR level was significantly lower than that of normal serum CysC group ( P<0.05). Spearman correlation analysis showed that serum CysC was negatively correlated with eGFR ( r=-0.744, P<0.001). In terms of pathological injury, the degree of renal tubular atrophy and renal interstitial fibrosis (T) and renal arteriole wall thickening (A) in high serum CysC group were more serious than those in normal serum CysC group ( P<0.05). Multiple linear regression analysis showed that the prevalence of hypertension, serum creatinine, urea, uric acid, T and A were correlated with serum CysC levels (standard regression coefficient β=0.048, 0.299, 0.260, 0.134, 0.195, 0.068, respectively, P<0.05). After adding serum CysC on the basis of clinical features, the prediction efficiency of renal tubular atrophy and renal interstitial fibrosis was higher (AUC were 0.829 [95% CI 0.787-0.870], 0.847 [95% CI 0.808-0.886], P<0.05). Conclusions:Patients with older age, hypertension, poor renal function and severe pathological damage are more likely to have elevated serum CysC levels. Serum CysC was related to the prevalence of hypertension, creatinine, urea, uric acid, T and A. Combined with serum CysC level can effectively improve the ability prediction of T.
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To analyze correlation among serum homocysteine (Hcy) ,Cysteine C (CysC) levels and severi‐ ty of coronary artery disease .Methods : A total of 220 coronary heart disease (CHD) patients treated in our hospital from Sep 2015 to Dec 2017 were selected as CHD group .According to Gensini score ,CHD group were divided into mild stenosis group (n＝ 63 ) ,moderate stenosis group (n＝ 71 ) and severe stenosis group (n＝ 86 ).Another 200 healthy people were enrolled as healthy control group .Serum Hcy and CysC levels were measured and compared a‐mong all groups .Correlation among serum Hcy , CysC levels and severity of coronary artery disease were analyzed . Results : Compared with healthy control group ,there were significant rise in serum Hcy [ (8.29 ± 1.02) μmol／L vs. (16. 14 ± 3.01) μmol／L] and CysC [ (0. 65 ± 0.11) mg／L vs.(1. 21 ± 0.12) mg／L] levels in CHD group .P＝0. 001 all.Compared with mild stenosis group ,there were significant rise in serum Hcy [(9. 31 ± 1.12) μmol／L vs.(12. 13 ± 3.32) μmol／L vs.(14.61 ± 3.82) μmol／L] and CysC [ (1.05 ± 0.21) mg／L vs.(1. 51 ± 0. 52) mg／L vs.(3.42 ± 1.01) mg／L] levels in moderate stenosis group and severe stenosis group ,and those of severe stenosis group were significantly higher than those of moderate stenosis group , P＝0.001 all.Pearson correlation analysis indicated that serum Hcy ( r＝0.431 , P＝0.004) , CysC ( r＝0.640 , P＝0. 003) levels were significant positively correlated with Gensini score .Conclusion :Serum Hcy and CysC levels is closely correlated with severity of coronary artery disease . Its detect is help for therapeutic effect and prognosis assessment for CHD patients .
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Objective: To measure serum levels of neutrophil gelatinase associated lipocalin (NGAL) and cystatin C (CysC) in patients with morning hypertension (MH) and explore their clinical value. Methods: A total of 120 outpatients or inpatients with essential hypertension (EH) were selected from our department of cardiology. According to MH definition, they were divided into MH group (n=62) and non-MH group (n=58). Levels of serum NGAL and CysC, blood lipids and blood glucose were measured and compared between two groups. Results: There were no significant difference in levels of blood lipids, blood glucose etc. between two groups, P＞0. 05 all; compared with non-MH group, there were significant rise in serum levels of NGAL [(47. 50±3. 15) μg/L vs. (156. 87±18. 56) μg/L]and CysC [(0. 68±0. 16) mg/L vs. (1. 26±0. 86) mg/L]in MH group, P=0. 001 both. Conclusion: Serum levels of NGAL and CysC in MH patients are significantly higher than those of non-MH patients, which is of great significance for diagnosing early renal dysfunction in MH patients. Therefore, management of morning blood pressure should be strengthened in clinic.
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Objective To investigate the single nucleotide polymorphism at G-395A site of the Klotho (KL) gene and to analyze its correlation with the coronary heart disease(CHD) and serum Cystatin C(Cys C) level in the elderly Chinese Han population in central China.Methods A case-control study was conducted in 278 elderly Chinese Han population in this department,who were divided into CHD group(138 cases)and control group(140 cases) according to bear angiography coronary or not.G-395A polymorphism of KL gene was determined by TaqMan Gene probe method,and the relationship between G-395A polymorphism and coronary heart disease and serum Cys-C level was analyzed.Results Compared with the control group,the frequency of GG genotype of G-395A in CHD group was significantly higher,and the frequency of AA genotype and AG genotype was not statistically significant.The levels of Cys-C in the GG genotype were higher than those in the AA and AG genotypes both in the control group and coronary heart disease group.Conclusion In the elderly Han population in central China,the risk of suffering coronary heart disease is higher among the GG genotype of the G-395A locus of the KL gene.KL gene G-395A site gene mutation may affect the development of atherosclerosis by affecting blood Cys-C levels.
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Objective To investigate the relationship between serum cystatin C (Cys C) level and the occurrence of in-stent restenosis after coronary drug-eluting stent implantation.Methods A retrospective analysis of coronary drug-eluting stent implantation was curried out in 592 patients.All patients were from Shengjing Hospital of China Medical University by coronary angiography,and were divided into restenosis group (142 cases) and non restenosis group (450 cases).The Cys C levels before and after surgery and follow-up angiography were analyzed.The biochemical indicators,and transcatheter arterial restenosis were analyzed.Results Either before or after operation and follow-up angiography,serum cystatin C levels were higher in restenosis group patients than that in non restenosis group [before operation:(1.622 ± 1.063) mg/L vs (1.369 ± 0.860) mg/L;after the operation:(1.769 ± 1.062) mg/L vs (1.458 ± 0.883) mg/L;review:(1.924 ± 1.085) mg/L vs (1.440 ± 0.874) mg/L;P ＜ 0.05].Multivariate COX regression analysis showed that serum cystatin C level was an independent risk factor of in-stent restenosis in drugeluting area (P ＜ 0.05).Conclusions The serum cystatin C level is closely related to in-stent restenosis in drug-eluting stents area.High level of serum cystatin C is an independent risk factor of in-stent restenosis after drug-eluting stents implantation.
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Objective To study the relationship between serum cystatin C(Cys C)level and the development of insulin resistance(IR)in elderly patients with type 2 diabetes mellitus (T2DM).Methods A cross-sectional survey research involving 757 elderly patients with T2DM was performed and patients were divided into groups according to Cys C and IR levels.Serum 1evels of fasting insulin (FBI),fasting blood glucose(FPG),fasting C-peptide (FCP),glycosylated hemoglobin A1 c (H bA1 c),homeostasis model assessment of insulin resistance (IR) (HOMA2 IR-C),homeostasis model assessment of insulin secretion,homeostasis model assessment of insulin sensitivity(HOMA2-％ S-C),micro-albuminuria(mALB)and serum lipid were measured and compared among the groups.Possible influence factors were adjusted,and the correlation between Cys C levels and IR was analyzed.The influencing factors on IR were also analyzed.Results There were statistically significant differences in ages,course of T2 DM,FBI,FCP,HbA1c,urinary mALB,IR,insulin secretion,insulin sensitivity,morbidity rate of coronary heart disease,hypertension and diabetic nephropathy among the three groups(allP＜0.05).Insulin sensitivity was decreased with the increase of Cys C level,while others were increased.Among 757 patients,the level of serum Cys C was positively correlated with FCP,HOMA2-IR C levels,and was negatively correlated with HOMA2-％ S-C levels(P＜0.05).Multiple logistic regression analysis showed that the higher level of Cys C was independent risk factors for IR in elderly T2DM patients(OR=3.41,95％CI:2.22-5.22,P＜0.05).Conclusions Serum Cys C level is closely related with IR in elderly T2DM,and the elevated level of serum Cys C is one of independent risk factors for elderly T2DM.
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Objective: To study diagnostic and predictive value of levels of high sensitive C reactive protein (hsCRP) and cystatin C (CysC) for acute coronary syndrome (ACS) in aged patients.Methods: A total of 60 ACS patients (ACS group) treated in our hospital and 60 healthy subjects (healthy control group) undergoing physical examination during Dec 2013 to Sep 2015 were randomly selected.Serum levels of hsCRP and CysC, and abnormal rates of hsCRP and CysC were measured and compared between two groups.Results: Compared with healthy control group, there were significant rise in serum levels of hsCRP[(3.02±1.13) mg/L vs.(7.95±2.38) mg/L]and CysC[(0.75±0.11) μg/ml vs.(1.35±0.43) μg/ml], and abnormal rates of hsCRP (0 vs.13.33%) and CysC (0 vs.11.67%) in ACS group, P<0.01 all.Conclusion: Serum hsCRP and CysC level measurements can effectively predict and assess occurrence, development and prognosis of disease in ACS patients, and provide clinical valid evidence for its diagnosis, prevention and treatment.
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Cysteine protease inhibitor SN (Cystatin SN) is a secretory protein encoded by CST1,with the promotion of cell senescence and apoptosis activity,playing an important role in the regulation of proteolytic activity.Many studies have found that Cystatin SN is abnormally expressed in various kinds of tumors,and is closely related with the tumorigenesis and progression.Cystatin SN may play an important role in the diagnosis and prognosis of tumors.
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Objective To explore the influence of obstruction sleep apnea syndrome (OSAS) on plasma cystatin C (CC) levels in patients with primary hypertension.Methods A total of 244 cases of primary hypertension patients was chosen.The patients were divided into observation group (with OSAS) and control group (without OSAS) according to apnea hypopnea index (AHI).The observation group was then divided into three subgroups:mild OSAS group,moderate OSAS group,and severe OSAS group.The levels of CC were compared.Results First,the plasma CC levels in patients with primary hypertension had no statistical significance in the differences among different grades of hypertension (P ＞ 0.05).Second,CC levels of observation group were significantly higher than control group (P ＜ 0.05).Third,CC levels of the severe group were higher than the moderate group,and the plasma CC levels of the moderate group were also higher than the mild group and control group.Rank correlation analysis and comparison of CC levels and AHI showed that CC levels were positively correlated with AHI (r =0.585,P ＜ 0.01).However,there were no statistically significant differences between CC levels of the mild OSAS group and control group (P ＞ 0.05).Conclusions The patients with OSAS and primary hypertension had higher levels of CC,and aggravated with the progress of the degree of obstruction.CC may be involved in the progression of the disease,a high level of CC may aggravate the condition,it should be early prevention and treatment.
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Objective To investigate the effect of oxiracetam on (Hcy), high sensitive C-reactive protein (hs-CRP), uric acid (UA) and cysteine protease inhibitor (Cys C) and blood lipid index level in patients with acute cerebral hemorrhage.Methods 98 patients with acute cerebral hemorrhage were randomly divided into observation group ( n =49 ) and control group ( n =49 ) .The control group was given routine treatment, the observation group was given oxiracetam treatment on the basis of control group.Two groups were treated for 2 weeks.Results The observation group after treatment NIHSS score lower than control group(P<0.05), GCS score and ADL score higher than control group (P<0.05);The serum levels of Hcy, hs-CRP, Cys, C levels lower than control group post-treatment, while the level of UA was higher than that of control group (P<0.05);The observation group TG, TC, LDL-C levels were lower than control group post-treatment ( P <0.05 ); Two groups had no severe adverse reactions. Conclusion Oxiracetam by reducing and Hcy in patients with acute cerebral hemorrhage hs-CRP, Cys C level, increased UA level, and improve blood lipid function, and thus improve symptoms.
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Objective To investigate the correlation between serum cystatin-C (Cys-C) levels and cognitive impairment.Methods A perspective study involving 273 patients in our hospital was performed from 2013 to 2015.They were divided into the cognitive impairment group and the control group.Cys-C measurement results and cognitive impairment assessment scores were collected.Possible influence factors were adjusted,and the correlation between Cys-C levels and mild cognitive impairment was analyzed.Results The distribution of age,hypertension,diabetes mellitus,smoking,drinking,dyslipidemia,and creatinine showed significant differences between the groups at different Cys-C levels (all P＜0.05).There was a significant difference in the Cys-C level between the cognitive impairment group and the control group [(0.727±0.082) mg/L vs.(0.514±0.045)mg/L,t=23.68,P＜0.01].The Cys-C level was negatively correlated with the scores of mini-mental state examination (MMSE) and Montreal cognitive assessment (MOCA) in the cognitive impairment group (r =-0.318 and -0.572,P＜0.05).The incidence of cognitive impairment was elevated with increasing Cys-C levels (x2 =13.12,P＜0.01).Logistic regression analysis showed that high levels of Cys-C (OR=3.298,95％ CI:1.417-7.675,P=0.001),history of diabetes mellitus (OR=7.971,95％ CI:3.036-31.562,P =0.03),education level (OR =2.237,95 ％ CI:1.022-4.896,),smoking (OR =5.692,95 ％ CI:1.060-2.614),drinking (OR=1.227,95％ CI:0.083-1.228),and dyslipidemia (OR=2.267,95％ CI:1.177-4.366) are independent risk factors for cognitive impairment.Conclusions High serum cystatin C levels are closely correlated with the risk of cognitive impairment occurrence.
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Objective To prospectively evaluate the value of cystatin C (CysC) in diagnosis of contrast-induced acute kidney injury (CIAKI) among patients undergoing Percutaneous Cardiovascular Intervention (PCI).Methods Patients who underwent PCI procedures in our hospital were enrolled.Serum creatinine(SCr) and CysC were measured at baseline before,24 h and 48 h after PCI,respectively.CysC were examined by particle-enhanced turbidimetric immunoassay (PETIA).CIAKI was defined as a relative increase in SCr concentration of at least 25％ or an absolute increase more than 44.8 mmol/L (0.5 mg/dl) within 48 h in the absence of other related causes.Results Among 196 patients,135 were male and 61 female with a mean age of(70.4 ± 11.3)years old.Twenty-nine (14.8％)patients developed CIAKI according to the SCr criteria.The area under the ROC curve (AUC) at 24 h and 48 h post PCI were 0.661 (95％ CI 0.548-0.774,P =0.006) and 0.783 (95％ CI 0.701-0.865,P ＜ 0.001),respectively.The diagnostic sensitivities of CysC at 24 h and 48 h were between 6.9％ and 48.28％,while,the diagnostic specificities and negative predictive values of CysC were between 85.03％-97.60％ and 85.79％-90.45％,respectively.The 15％ elevation of 48 h CysC yielded the diagnostic sensitivity of 41.38％,specificity of 92.86％,negative predictive value of 90.17％,corrective rate of 85.28％ with Youden Index of 0.342 4.Conclusions In this study,CysC presented an excellent diagnostic specificity and negative predictive value in diagnosis of CIAKI.It might be used as a tool for excluding CIAKI in clinical practice.48 h CysC performed better than 24 h CysC in CIAKI diagnosis,among which a 15％ increment achieved relatively the best diagnostic value.
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Objective To investigate the levels of cystatin C (CC) with the H&Y scale and duration of Pakinson's disease(PD)patients.Methods The study consists of 432 PD patients and 513 control subjects.PD patients were divided into 3 subgroups according to their H&Y scale.The levels of CC and Scr were measured.The statistics analysis was used to evaluate their associations.Results In PD and control groups, CC concentrations were significantly different (P ＜ 0.05), and Scr concentrations in two study groups were not significantly different(P ＞ 0.05).PD in each subgroup, CC concentrations in the medium group were significantly higher than the early and control groups, and CC in the late group was significantly higher than the other two subgroups.Rank correlation analysis and comparison of CC concentration and duration and H&Y score showed that CC concentration was positively correlated with the duration of PD(r =0.209, P ＜0.01), and that CC concentration and H&Y score were significantly positively correlated (r =0.618, P ＜0.01).Conclusions There was a certain correlation between CC levels and PD, and CC levels of PD patients were significantly higher.There was no significant increased CC in the initial stages of the disease, perhaps CC was not necessary cause of the onset of PD.However, the level of CC with H&Y stage and duration were positively correlated, perhaps CC may be involved in the process of disease progression, because high level of CC may increase PD patient's condition.
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Objective:To assess effect of detection of plasma N terminal pro brain natriuretic peptide (NT‐proBNP) and serum cystatin C (Cys C) combined Global Registry of Acute Coronary Events (GRACE) score on heart func‐tion and prognosis in patients with acute coronary syndrome (ACS) .Methods :According to GRACE score ,a total of 136 ACS patients were divided into low risk group (n=29) ,intermediate risk group (n=39) and high risk group (n=68) .Serum Cys C level and plasma NT‐proBNP level were measured in all groups .Incidence rate of major ad‐verse cardiovascular events (MACE) within three and six months was counted .Results:Among ACS patients ,com‐pared with low risk group ,there were significant rise in levels of NT‐proBNP [ (165.80 ± 51.62) ng/L vs .(193.13 ± 74.64) ng/L vs .(985.45 ± 152.69) ng/L] and Cys C [ (0.83 ± 0.38) mg/L vs .(0.9 ± 0.25) mg/L vs .(1.23 ± 0.23) mg/L] ,left ventricular end‐diastolic diameter [six months: (50 ± 3) mm vs .(55 ± 3) mm vs .(59 ± 5) mm] ,significant reduction in left ventricular ejection fraction [LVEF ,six months: (55 ± 7)% vs .(49 ± 5)% vs . (40 ± 7)% ] ,and significant rise in incidence rate of MACE (six months:2.94% vs .9.55% vs .30.88% ) ,and a‐bove indexes in high risk group were significantly higher than those of intermediate risk group except LVEF signifi‐cantly reduced , P<0.05 or <0.01 ;Pearson correlation analysis indicated that NT‐proBNP and Cys C levels were positively correlated with GRACE score (r=0.72 , P<0.05 ; r=0.65 , P<0.05) respectively .Conclusion:NT‐proBNP and Cys C level detection combined GRACE score could exactly response heart function and prognosis .
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Objective:To measure serum level of cystatin C (Cys C)in patients with essential hypertension (EH)and analyze its correlation with pulse pressure (PP).Methods:A total of 60 EH patients and 30 cases with normal physi-cal examination results were selected.According to PP level,EH patients were divided into PP>60mmHg group (n=29)and PP≤60mmHg group (n=31).Serum Cys C concentration was measured by latex particle-enhanced immu-noturbidimetric method in two groups,and the results were statistically analyzed.Results:Cys C level of PP >60mmHg group was significantly higher than that of PP≤60mmHg group,and the both groups were significantly higher than that of normal control group [(1.40±0.06)mg/L vs.(1.19±0.54)mg/L vs.(0.72±0.20)mg/L], P <0.05 all;linear correlation analysis indicated that Cys C level was positively correlated with PP (r =0.325,P <0.05)and systolic blood pressure (SBP,r = 0.399,P < 0.05),and PP was positively correlated with SBP (r =0.876,P <0.01)in EH group.Conclusion:Cys C level is positively correlated with PP in EH patients.Cys C level can be used as an early index detecting renal function damage caused by hypertension.
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Objective To assess and compare the roles of plasma concentrations of neutrophil gelatinase associated lipocalin (NGAL) and Cystatin C for early diagnosis and treatment of septic acute kidney injury (AKI) in adult Surgical critically ill patient . Methods One hundred patients were divided into two groups ,the group of 63 cases of AKI and AKI group of 37 cases ,plasma NGAL and Cystatin C level of the 2 groups were determined by the method of enzyme‐linked immunosorbent (ELISA) ,latex en‐hanced immune turbidimetry (PETIA) respectively on arrival in the surgical intensive care unit(SICU) (T0 ) and 24 h after arrival in SICU(T1 ) .Results Compared with patients in non AKI group ,both plasma NGAL and Cystatin C level of patients in AKI group on T0 and T1 increased significantly ,the difference between the two groups had significant statistical difference (P<0 .01);Although ,plasma NGAL on T1 performed less well (AUC=0 .69) ,with a threshold value of 92 ng/mL(70 .3% sensitivity ,57%specificity) .Plasma NGAL showed significant discrimination for AKI diagnosis (AUC=0 .85) with a threshold value of 65 .95 ng/mL(81 .8% sensitivity ,76 .2% specificity) on T0 .Both plasma Cystatin C on T0 and T1 worked well for the diagnosis of AKI (AUC=0 .90 ,0 .88 ,thresholds 1 .49 and 1 .47 mg/L ,respectively) ,with diagnostic sensitivity of 89 .2% ,82 .5% respectively ,speci‐ficity of 83 .8% ,76 .2% respectively .Conclusion Plasma NGAL and Cystatin C are useful markers in predicting AKI in surgical critically ill patients ,the early diagnosis value of plasma Cystatin C for AKI is better than plasma NGAL on arrival in the surgical intensive care unit .
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Objective To evaluate the early diagnosis value of serum cystatin C in the pediatric intensive care unit (PICU) children with septic acute kidney injury.Methods A total of 196 children in PICU confirmed with sepsis in Hunan Province Children's Hospital was enrolled in this study.Patients were divided into acute kidney injury (AKI) and non-AKI group according to whether accompanied with acute kidney injury.The serum cystatin C and serum creatinine were collected in 2 h,48 h,and 96 h after admission,and the clinical data were collected.The serum Cys C was drawn in receiver operating characteristic (ROC) curve.The sensitivity and specificity of Cys C were evaluated in diagnosis of septic AKI.Results The incidence of septic AKI was 35.20％,higher Cys C levels were risk factors for the onset of AKI,and OR was 26.218 (95％ CI:6.235 ～ 110.232).In AKI group,the serum Cys C level in 2 hours after admission was (2.05 ± 0.90)mg/L,which was higher than 48 hours (1.72 ± 0.72)mg/L and 96 hours (1.62 ±0.95) mg/L(Z =2.169,P =0.030; Z =2.789,P =0.005).In the septic AKI group,cystatin C and creatinine were positive correlation (r =0.582,P =0.000).The area under the ROC curve at 2hours after admission for serum cystatin C in diagnosis of AKI was 0.831.A cutoff point of 1.325 mg/L for 2 hours after admission was identified for cystatin C in the diagnosis of septic AKI,with a sensitivity of 87.1％and specificity of 78.9％.Conclusions Higher level of Cys C was risk factor for the onset of AKI.Compare to creatinine,cystatin C was earlier increased in children with septic AKI and positively correlated with it.It might be a biomarker for early diagnosis of septic AKI in PICU critical ill children.
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Objective To investigate the change and clinical value of serum cystain C(CysC)level in the patients with HBeAg-negative chronic hepatitis B(CHB).Methods 212 cases of CHB in our hospital were selected and divided into the HBeAg-negative group and the HBeAg-positive group according to the HBeAg status.105 healthy individuals at the same time were enrolled as the control group.The levels of serum CysC,ALT,AST,Cr,BUN and HBV DNA in 3 groups were detected and compared.The corre-lations between serum CysC with AST,AST,Cr,Bun,HBV DNA were analyzed by the Pearson correlation analysis.Results The mean CysC level in the HBeAg-negative group was (1 .40±0.36)mg/L,which was higher than (0.93±0.12)mg/L in the control group and (0.96±0.18)mg/L in the HBeAg-positive group,the differences between them was statistically significant(P <0.05). The CysC was significantly positively correlated with serum Cr level in the HBeAg-negative group(r=0.840,P <0.01).Conclusion The CysC level might be used as an effective index for monitoring the early kidney injury in the patients with HBeAg-negative CHB,which has important significance in the prevention and treatment of HBeAg-negative CHB.
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Objective:To explore the relationship among serum neutrophil gelatinase associated lipocalin (NGAL), cystatin C (Cys-C) levels and cardiac, renal function;and diagnostic value of NGAL and Cys-C for early renal damage in aged patients With coronary heart disease (CHD).Methods:According to NYHA cardiac function classi-fication,a total of 84 aged CHD patients Were divided into class I group (n=30),class Ⅱ group (n=28)and classⅢ-Ⅳ group (n=26).Another 31 aged healthy objects Were selected as healthy control group.Serum N terminal pro B-type natriuretic peptide (NT-proBNP),NGAL and Cys-C etc. levels Were measured,and the correlation a-mong serum NGAL,Cys-C levels and cardiac function,estimated glomerular filtration rate (eGFR)Were analyzed. The accuracy of serum NGAL and Cys-C diagnosing renal insufficiency Was evaluated by receiver operator character-istic curve (ROC).Results:Along With NYHA class increased,there Were significant increase in serum levels of NGAL [(36.96±21.23)μg/L vs.(87.80±61.40)μg/L vs.(141.21±92.96)μg/L vs.(198.15±98.46)μg/L] and Cys-C [(0.75±0.64)mg/L vs.(1.40±1.88)mg/L vs.(2.33±2.03)mg/L vs.(3.45±1.81)mg/L]in healthy control group,NYHA I,Ⅱ,Ⅲ-Ⅳ groups,and they Were highest in NYHA class Ⅲ-Ⅳ group,there Was significant difference in serum NGAL level betWeen any tWo groups among the four groups (P0.05). Pearson correlation analysis indicated that serum NGAL and Cys-C levels Were positively correlated With NT-proBNP (r=0.842,0.718,P<0.01 both),and negatively correlated With eGFR (r=-0.689,-0.448,P<0.01 both), and serum NGAL level had closer correlation With NT-proBNP and eGFR.Area under ROC of serum NGAL and Cys-C Were 0.884 and 0.744 respectively in diagnosing renal insufficiency.Conclusion:Serum NGAL and Cys-C lev-els have good correlation With cardiac and renal function in aged CHD patients,Which are sensitive and accurate in-dexes for diagnosing early renal damage.
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Objective:To explore the clinical significance of combined detecting serum cystatin C (Cys-C),retinol binding protein (RBP),high sensitive C reactive protein (hsCRP)and urine microalbuminuria (UMA)for early re-nal damage detection in patients With essential hypertension (EH).Methods:Levels of Cys-C,RBP and UMA Were measured in 83 EH patients (EH group)and 80 healthy objects With similar age (healthy control group)respective-ly.Positive rates (exceeding upper limit of normal value for above index Was regarded as positive) of single and combined use of above indexes Were calculated.Results:Compared With healthy control group,there Were signifi-cant increase in levels of Cys-C [(0.98±0.30)μg/ml vs.(1.23±1.38)μg/ml],RBP [(38.32±10.10)mg/L vs. (41.67±11.68)mg/L],and UMA [(1.17±0.46)mg/L vs.(3.01±3.31)mg/L]in EH group (P<0.05 or <0.01),and their detection rates for early renal damage Were 21.69%,19.28%,14.46% and 19.28% respectively. Combined detecting rates of Cys-C + UMA and UMA+ RBP Were 36.14% and 34.94% respectively,Which Were significantly higher than those of single index (P<0.05 all).Conclusion:Proper multi-index combined detecting can effectively raise the detection rate of early renal damage in patients With hypertension.