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OBJECTIVE@#To investigate the diagnostic efficacy of seven glomerular filtration rate (GFR) evaluation formulas Schwartz2009, Schwartz1976, Counahan-Barratt, Filler, CKD-EPIscysc, Cockrofi-Gault, CKD-EPIScysC-Scr in high concentration of methotrexate (HDMTX) chemotherapy dose adjusted cut-off point (GFR ≤85 ml/min) in children with acute lymphoblastic leukemia (ALL).@*METHODS@#One hundred and twenty-four children with ALL were included in the study. GFR determined by renal dynamic imaging (sGFR) was used as the standard to evaluate the accuracy, consistency of eGFR calculated by seven formulas and sGFR, and the diagnostic efficacy of each formula when the sGFR ≤85 ml/min boundary.@*RESULTS@#All of the accuracy of eGFR estimated by Schwartz2009 were greater than 70% in the 0-3, >4 and ≤6, >6 and ≤9, >9 and ≤16 years old group and male group, and the consistency exceeded the professional threshold. When the sensitivity of the ROC curve sGFR ≤85 ml/min was 100% of CKD-EPIscysc in the 0-3, >3 and ≤4 years old group, Filler in the >3 and ≤4 years old group, and Cockrofi-Gault in the >6 and ≤9 years old group, the specificity was 73.02%, 78.95%, 78.95%, 69.32%, respectively, and the AUC under the ROC curve was the largest (P<0.05).@*CONCLUSION@#Schwartz2009 formula predicts the highest accuracy of eGFR in the 7 glomerular filtration rate. CKD-EPIscysc, Filler, and Cockrofi-Gault formulas have more guiding signi-ficance for the adjustment of HDMTX chemotherapy in pre-adolescence in children with ALL when sGFR ≤85 ml/min.
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Adolescent , Humans , Male , Child , Child, Preschool , Glomerular Filtration Rate , Methotrexate , Creatinine , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Renal Insufficiency, Chronic/diagnosisABSTRACT
Objective To evaluate the predictive values of serum neutrophil gelatinase-associated lipocalin (NGAL), urine NGAL, serum cystatin C (Cys-C) and serum creatinine (Scr) for early delayed graft function (DGF) in kidney transplant recipients. Methods Clinical data, blood and urine samples of 159 kidney transplant recipients were collected. All recipients were divided into the DGF group (n=42) and immediate graft function (IGF) group (n=117) according to the incidence of DGF. Clinical data of all recipients were analyzed. The changes of serum NGAL, urine NGAL, Cys-C and Scr levels were statistically compared between two groups. The predictive values of different markers for early DGF were assessed. Results Among 159 kidney transplant recipients, DGF occurred in 42 cases with an incidence rate of 26.4%. There were statistically significant differences in donor age, cold ischemia time of donor kidney and complement-dependent cytoxicity (CDC) between the two groups(all P < 0.05). Within postoperative 2 weeks, the serum NGAL levels in the DGF group were higher than those in the IGF group (all P < 0.05). The Cys-C, Scr and urine NGAL levels in the DGF group were higher compared with those in the IGF group within 3 weeks after kidney transplantation(all P < 0.001). Serum NGAL, urine NGAL, Cys-C and Scr levels had certain predictive values for early DGF in kidney transplant recipients. Cys-C yielded the highest predictive value with a cut-off value of 4.73 mg/L, sensitivity of 0.833, specificity of 0.812 and area under the curve (AUC) of 0.895. Conclusions Cys-C has higher predictive value for early DGF in kidney transplant recipients compared with serum NGAL, urine NGAL and Scr.
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Objective::To observe the effect and mechanism of modified Si Junzitang combined with heat-sensitive moxibustion on interleukin-17(IL-17), interleukin-22(IL-22), interleukin-1α(IL-1α) and serum cystatin C(Cys-C )in serum and exhale breath condensate(EBC) of patients with chronic obstructive pulmonary disease at stable stage(COPD, Qi deficiency of lung and spleen). Method::Totally 120 cases of COPD(Qi deficiency of lung and spleen) treated in pulmonary department and thermal moxibustion department of Affiliated Hospital of Jiangxi University of traditional Chinese medicine from January 2019 to June 2019 were included and randomly divided into traditional Chinese medicine group, heat-sensitive moxibustion group and control group. The patients in traditional Chinese medicine group were treated with Si Junzitang, the patients in heat-sensitive Moxibustion group were treated with heat-sensitive moxibustion in addition to traditional Chinese medicine group, and the patients in control group were treated with placebo. All of the 3 groups were treated with oxygen and bronchodilator according to the guidelines. All groups received 3 consecutive courses of treatment, 20 days per course. After 3 courses of treatment, the clinical efficacy of the three groups, the forced expiratory volume in one second (FEV1), the forced expiratory volume in the estimated value in one second (FEV1%), the forced vital capacity (FVC), and IL-17, IL-22, IL-1α in serum and exhale breath condensate (EBC) were measured. Result::There were no statistically significant difference in general clinical data, lung function levels (FEV1, FEV1%, FVC), serum and EBC levels of IL-17, IL-22, IL-1α and Cys-C in the first three groups. The total clinical effective rate of traditional Chinese medicine group was better than the control group (P<0.05), the heat-sensitive moxibustion group was better than the traditional Chinese medicine group (P<0.05) and significantly better than the control group (P<0.01). Compared with the patients before treatment, the level of lung function was improved, while IL-17, IL-22, IL-1α and Cys-C in serum and EBC were reduced(P<0.05). The traditional Chinese medicine group was superior to that in the control group (P<0.05), the heat-sensitive moxibustion group was superior to that in the traditional Chinese medicine group (P<0.05) and significantly superior to that in the control group (P<0.01). Conclusion::Modified Si Junzitang combined with heat-sensitive moxibustion has an anti-inflammatory effect on COPD by stimulating bullishness of human body, improving body immunity, inhibiting inflammatory cytokines, reducing levels of inflammation cytokines IL-17, IL-22, IL-1α, and chronic inflammation markers serum Cys-C and inflammatory reaction, increasing the lung capacity, improving ventilation function and pulmonary function, so as to effectively relieve chest tightness asthma and other symptoms in COPD patients, and improve the clinical efficacy.
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Shortage of donor kidney is a major problem in renal transplantation. Accurate evaluation of donor kidney function may reduce the organ rejection rate and save more patients with uremia. Compared with pathological examination, detection of circulating molecular markers is more convenient in clinical application. In this article, the research progress on the markers of kidney injury, such as serum creatinine, serum cystatin C (Cys-C), neutrophil gelatinase-associated lipocalin (NGAL), liver-type fatty acid-binding protein (L-FABP), mitochondrial DNA (mtDNA), kidney injury molecule-1(KIM-1) and interleukin -18 (IL-18), were briefly reviewed.
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Background: Diabetic kidney disease is the leading cause of premature death in young diabetic patients. Detection of diabetic kidney disease as early as possible in the disease process currently offers the best chance of delaying or possibly preventing progression to end-stage renal disease. The present study was aimed to evaluate utility of serum cystatin C based eGFR for early diagnosis of diabetic kidney disease.Methods: Diagnosed patients of type 2 diabetes mellitus having frank proteinuria were excluded. Patients without proteinuria were tested for microalbuminuria. 50 patients having microalbuminuria were tested for 24 hour urine creatinine, serum creatinine and serum cystatin C. Both cystatin C based eGFR and eGFR by Cockcroft and Gault equation were compared with standard GFR by 24 hour urine Creatinine clearance respectively.Results: There was statistically significant positive correlation between cystatin C based eGFR and standard GFR by 24 hr Creatinine clearance (r=0.87). For eGFR by Cockcroft-Gault equation, it was 0.36 (r=0.36).Conclusions: The results of this study suggest that serum cystatin C based eGFR measurement is a useful, practical tool for the evaluation of renal involvement in the course of diabetes. As serum creatinine values are affected by many factors like age, sex, muscle mass and diet, serum cystatin C based eGFR estimation offers a hope that diabetic kidney disease can be well prevented with appropriate interventions.
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Objective: To observe the effect and mechanism of modified Buzhong Yiqi Tang and pursed-lips breathing (PLB) on serum tumor necrosis factor-alpha (TNF-α), interleukin-8 (IL-8), IL-6, IL-1β and serum cystatin C (Cys-C) in patients of chronic obstructive pulmonary disease (COPD) at the stable stage. Method: Totally 120 cases of COPD treated at Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from September 2017 to March 2018 conformed to the inclusion criteria, and were randomly divided into treatment group (60 cases) and control group (60 cases). Cases of control group received Tiotropium (18 μg/time, qd). In addition to the therapy of control group, cases of treatment group were also given Buzhong Yiqi Tang and PLB. Both groups were treated for 6 months. Percent of forced expiratory volume in one second in predicted value (FEV1%), ratio of FEV1 to forced vital capacity (FEV1/FVC), six-minute walk distance (6MWD),TNF-α, IL-8, IL-6, IL-1β and Cys-C were compared between both groups. Result: After treatment, the clinical efficacy rate of observation group was 93.33%, which was evidently higher than 86.67%of control group (Pa,IL-8, IL-6,IL-1β, Cys-C but increases in FEV1%, FEV1/FVC (Pa, IL-8, IL-6, IL-1β, Cys-C but increases in FEV1%, FEV1/FVC (PConclusion: Buzhong Yiqi Tang and PLB has an anti-inflammatory effect on COPD by reducing levels of inflammation cytokines TNF-α, IL-8,IL-6, IL-1β and chronic inflammation markers serum Cys-C and inflammatory reaction, and alleviating airflow obstruction, promoting the levels of FEV1%, FEV1/FVC, pulmonary function control inflammatory factors, so as to improve pulmonary function and the quality of life in patients with COPD.
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Objective To investigate the correlations among homocysteine(Hcy)level,serum cystatin C (Cys-c)and diabetic peripheral neuropathy(DPN).Methods Two hundred and three diagnosed cases of type 2 diabetes were enrolled,including 123 DPN patients(DPN+)and 80 non-DPN(DPN-)patients.Levels of serum Hcy,Cys-c,high-sensitivity C-reactive protein(hs-CRP)and fiber fibrinogen(Fg)were detected.The above indi-cators and the baseline data such as sex,age,duration,BMI,WHR,HOMA-IR(CP),HOMA-islet(CP)were statistically analyzed. Results Hcy,Cys-c,and the duration of the DPN+ group were significantly higher than those in the DPN-group(P<0.05,respectively).HOMA-islet(CP)in the DPN-group was markedly higher than that in the DPN+group(P<0.01).The prevalence of DPN in the high level of Hcy group was much higher than that in the low and the normal level of Hcy group.Hcy was still significantly correlated with the Cys-c after taking the controlled procedure such as duration and fibrinogen. Conclusion High levels of Hcy and Cys-c are the criti-cal risk factors of DPN,collaborative determination of Hcy and Cys-c level might be of quitevaluable in early diag-nosis of DPN.
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Objective To study the clinical significance of serum cystatin C (Cys C) in patients with acute leukemia (AL). Methods A total of 59 newly diagnosed AL patients in Xinghua City People's Hospital from January 2014 to August 2017 were enrolled; meanwhile, 59 healthy individuals who underwent physical examination at Medical Center of Xinghua City People's Hospital were selected as the control group. AU5800 automatic biochemical analyzer from American Beckman Coulter Corporation was applied to detect the levels of serum Cys C, lactate dehydrogenase (LDH) and creatinine (Cr). The receiver operating characteristic (ROC) curve was also drawn. Results The levels of serum Cys C and LDH in AL patients were higher than those in the control group [serum Cys C: (1.36±0.72) mg/L vs. (0.76±0.27) mg/L; LDH: (456±362) U/L vs. (185±29) U/L], and there was a statistical significance (t＝-5.965, P＝0.000; t＝-5.718, P＝0.000). There was no statistical difference in the serum Cr between AL patients and control group [(86±26) μmol/L vs. (82±16) μmol/L] (P＞ 0.05). There was a positive correlation between levels of serum Cys C and LDH in AL patients (rs＝ 0.447, P < 0.05). The ROC area under curve of serum Cys C was 0.823, the standard error was 0.037, and the confidence interval of 95 % was 0.751-0.896. The ROC area under curve of serum LDH was 0.811, the standard error was 0.042, and the confidence interval of 95 % was 0.728-0.894. Conclusion The level of serum Cys C in AL patients is higher than that in the healthy population. The detection of serum Cys C is helpful in the diagnosis of AL and the evaluation of tumor burden, which is consistent with serum LDH.
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Objective To evaluate the early diagnostic value of urinary insulin-like growth factor binding protein-7 (IGFBP-7) in sepsis-induced acute kidney injury (AKI),and to compare the effects of urinary IGFBP-7 to that of serum cystatin-C (sCys-C) and serum creatinine (sCr) on predicting the severity of sepsis-induced AKI patients.Methods A total of 105 patients with sepsis admitted to ICU in Tianjin First Hospital from September 2015 to August 2016 were divided into AKI group (n =48) and non-AKI group (n =57) according to the AKI diagnostic criteria.The samples of blood and urine of the patients were collected at 0,3,6,12,24 and 48 h,to measure the levels of urinary IGFBP-7,and serum Cys-C and sCr.Based on the receiver operating characteristic curve (ROC) and the area under the curve (AUC),the early diagnostic value of urinary IGFBP-7,and serum sCys-C and sCr in sepsis-induced AKI patients was determined.Results With the increase in length of ICU stay,the levels of urinary IGFBP-7,and serum sCys-C and sCr in AKI patients increased gradually.There was a significant difference between the two groups in the level of IGFBP-7 at 3 h [2.34 (2.03,4.19) ng/mL vs.1.79 (1.51,2.62) ng/mL,P ＜0.05].At 6 h,the difference in sCys-C between two groups was statistically significant [(1.63 ± 0.42)ng/mL vs.(1.20 ±0.46) ng/mL,P ＜ 0.05].At 12 h,the difference in sCr between two groups was statistically significant [80.5 (74.3,88.0) ng/mL vs.77.0 (67.0,84.0) ng/mL,P ＜ 0.05].The AUCs of urinary IGFBP-7 and sCys-C of sepsis-induced AKI patients were 0.881 (95％ CI:0.813-0.949) and 0.782 (95％ CI:0.692-0.872),which were superior to those in AUC of sCr 0.629 (95％CI:0.522-0.737).When the cutoff value of urinary IGFBP-7 was 1.82 ng/mL,the sensitivity was 93.8％ and the specificity was 77.2％.Conclusions Urine IGFBP-7 and sCys-C have higher predictive value in sepsis-induced AKI than sCr,whereas urine IGFBP-7 is more sensitive and specific than sCys-C,suggesting that IGFBP-7 may be used as sepsis signs of early diagnosis of AKI.
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Objective To investigate the correlation of serum cystatin C(CysC) and N-terminal brain natriuretic peptide (NT-proBNP) levels with severity of coronary heart disease.Methods 240 patients with coronary artery disease were selected.According to coronary angiography,they were divided into four groups:52 cases of non-CAD group,coronary single vessel disease group (73 cases),62 cases of double vessel disease,53 cases of triple vessel disease group.The serum CysC,NT-proBNP levels were determined and compared among the four groups.The relationship between CysC,NT-proBNP levels and severity of coronary artery disease was analyzed.Results The CysC,NT-proBNP levels in the single coronary vessel disease group,double vessel disease group and multivessel disease group were higher than non-CHD group,the differences were statistically significant(t=2.019,3.870,7.449,P=0.046,0.000,0.000;t=6.068,15.365,24.851,P=0.000,0.000,0.000);and with the crown pulse lesion count increased,the serum CysC,NT-proBNP levels increased gradually,the differences were statistically significant(t=2.080,3.070,P=0.039,0.000;t=10.953,12.078,P=0.000,0.000).Coronary artery disease severity was positively correlated with CysC,NT-proBNP levels (r1=0.562,r2=0.503).Conclusion The severity of coronary artery disease is closely related to the levels of CysC,NT-proBNP,which has some predictive value for coronary artery disease,patients with high CysC,NT-proBNP levels should be given high priority.
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Objective:To investigate the changes and significances of serum cystatin C and transforming growth factor-β1 levels for the neonatal asphyxia.Methods:Forty-six asphyxia newborns were chosen as the asphyxia group,and thirty healthy newborns were selected as the control group.The TGF-β1,CysC,BUN,Scr,and GFR levels of both groups were detected on the 1st,3rd,7th day after hospitalization.According to the renal injury,the 46 newborns were divided into normal group and asphyxia group,and the serum indexes were detected and analyzed.Results:On the 1st,3rd,7th day after hospitalization,the TGF-β1,GFR of asphyxia group was obviously increased and was lower than those of the control group (P＜0.05);the level of CysC,BUN,Scr in both groups were decreased,and the change degree in asphyxia group were higher than that of the control group (P＜0.05);the CysC,BUN,Scr in renal injured group were higher than those of normal group,and TGF-β1,GFR were much lower (P＜0.05).Additionally,TGF-β1 level of renal injured group was negatively correlated to the BUN and Scr,and positively correlated with the GFR (P＜0.05).The level of serum CysC in renal injured group was positively correlated to BUN and Scr and negatively correlated to GFR (P＜0.05).Conclusion:The serum TGF-β1,CysC in asphyxia newborns had significant changes compared with the healthy newborns and was correlated to the renal injured indexes,which had clinical directive significance on the early diagnosis,condition judgment,and prognosis of neonatal asphyxia with renal injury.
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Objective To study the effects of acarbose combined with metformin in the treatment of newly diagnosed type 2 diabetes mellitus and its effects on levels of glycosylated hemoglobin and serum cystatin C.Methods 76 patients with newly diagnosed type 2 diabetes mellitus were divided into observation group and control group according to the order of admission.The control group was treated with metfonnin,the observation group was treated with acarbose combined with metformin.The levels of blood glucose and serum cystatin C before and after treatment in the two groups were compared.The clinical efficacy and side effects were analyzed.Results After treatment,the total effective rate in the observation group was significantly higher than that in the control group[89.47％ (34/38) vs.63.16％ (24/38)] (x2 =7.280,P ＜ 0.05).After treatment,the levels of glycosylated hemoglobin,postprandial blood glucose,fasting blood glucose and serum cystatin C in the observation group were significantly lower than those in the control group[(6.78 ±0.81)％,(7.01 ±0.22)mmol/L,(5.12 ±0.32)mmol/L,(0.82 ±0.11)mg/L vs.(7.99 ±0.85) ％,(9.49 ± 0.61) mmol/L,(7.32 ± 0.54) mmol/L,(1.41 ± 0.22) mg/L] (t =6.353,23.576,21.606,14.787,all P ＜ 0.05).There was no significant difference in the incidence rate of adverse reaction between the observation group and the control group [15.79％ (6/38) vs.13.16％ (5/38)] (x2 =0.106,P ＞ 0.05).Conclusion Acarbose combined with metformin can effectively reduce the levels of glycated hemoglobin and serum cystatin C in patients with newly diagnosed type 2 diabetes mellitus.The clinical efficacy is good and the adverse reaction rate is low.
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Objective:To investigate the correlation of the blood concentration of tacrolimus ( Tac) and serum cystatin C ( SCysC) and serum creatinine (Scr) in the patients with renal transplantation. Methods:Totally 84 cases of renal transplantation patients (67 male/17 female) treated with Tac were involved. The blood concentration of Tac, SCysC and Scr were monitored after the operation. Data results were categorized according to the postoperative time and the blood concentration. The correlations of Tac blood concentra-tion,SCysC and Scr were analyzed and compared by using Pearson correlation analysis. Results: The blood concentration of Tac was not significantly associated with SCysC and Scr in different postoperative time groups and different drug concentration groups ( P >0. 05). As the extension of time,the blood concentration of Tac showed a gradual declining trend, while SCysC and Scr levels de-creased first, and then increased gradually after two years of the operation. Conclusion:The blood concentration of Tac has no effect on the function evaluation of transplanted kidney by the biochemical indicators such as SCysC and Scr.
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Objective To evaluate the early diagnostic value of urinary insulin-like growth factor binding protein-7 (IGFBP-7) in sepsis-induced acute kidney injury (AKI),and to compare the effects of urinary IGFBP-7 to that of serum cystatin-C (sCys-C) and serum creatinine (sCr) on predicting the severity of sepsis-induced AKI patients.Methods A total of 105 patients with sepsis admitted to ICU in Tianjin First Hospital from September 2015 to August 2016 were divided into AKI group (n =48) and non-AKI group (n =57) according to the AKI diagnostic criteria.The samples of blood and urine of the patients were collected at 0,3,6,12,24 and 48 h,to measure the levels of urinary IGFBP-7,and serum Cys-C and sCr.Based on the receiver operating characteristic curve (ROC) and the area under the curve (AUC),the early diagnostic value of urinary IGFBP-7,and serum sCys-C and sCr in sepsis-induced AKI patients was determined.Results With the increase in length of ICU stay,the levels of urinary IGFBP-7,and serum sCys-C and sCr in AKI patients increased gradually.There was a significant difference between the two groups in the level of IGFBP-7 at 3 h [2.34 (2.03,4.19) ng/mL vs.1.79 (1.51,2.62) ng/mL,P ＜0.05].At 6 h,the difference in sCys-C between two groups was statistically significant [(1.63 ± 0.42)ng/mL vs.(1.20 ±0.46) ng/mL,P ＜ 0.05].At 12 h,the difference in sCr between two groups was statistically significant [80.5 (74.3,88.0) ng/mL vs.77.0 (67.0,84.0) ng/mL,P ＜ 0.05].The AUCs of urinary IGFBP-7 and sCys-C of sepsis-induced AKI patients were 0.881 (95％ CI:0.813-0.949) and 0.782 (95％ CI:0.692-0.872),which were superior to those in AUC of sCr 0.629 (95％CI:0.522-0.737).When the cutoff value of urinary IGFBP-7 was 1.82 ng/mL,the sensitivity was 93.8％ and the specificity was 77.2％.Conclusions Urine IGFBP-7 and sCys-C have higher predictive value in sepsis-induced AKI than sCr,whereas urine IGFBP-7 is more sensitive and specific than sCys-C,suggesting that IGFBP-7 may be used as sepsis signs of early diagnosis of AKI.
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Objective To investigate the relationship between serum cystain C,urinary neutrophil gelatinase?associated lipocalin(NGAL),uri?nary kidney injury molecule?1(KIM?1)and preeclampsia,and explore the value in predicting preeclampsia and early kidney damage. Methods A total of 30 cases of pregnant women with severe preeclampsia,30 cases of mild preeclampsia and 60 cases of healthy pregnant women admitted in the Second Hospital of Jilin University from October 2014 to July 2015 were enrolled for the study. ELISA was performed to check urinary KIM?1 and urinary NGAL,and the serum cystatin C was detected by immune turbidity method. Results KIM?1,NGAL,serum cystatin C in the preeclampsia were significantly higher than the normal control group(P<0.05). In addition,with the development of their concentrations,the progression of pre?eclampsia gradually rise;BMI,e?GFR,urine protein/creatinine ratio,KIM?1,serum scystatin C and NGAL are the risk factors for preeclampsia;uKIM?1,serum scystatin C and NGAL and combined predictors of preeclampsia are taken as the early indicators of renal injury,which sensitivity are separately 83.3%,75%,88.9%,96.8%;specificity are respectively 72.7%,70%,75.6%,86.4%. Conclusion KIM?1,serum scystatin C and NGAL may reflect the progression of renal injury in preeclampsia .Combined predictors have a higher predictive value in the early renal injury of the preeclampsia.
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Objective To observe the changes of serum cystatin C(Cys C) in patients with coronary heart disease(CHD) and normal kidney function ,and evaluate the predictive value of Cys C concentration on coronary arterial lesions .Methods Serum levels of Cys C were detected in 316 patients with coronary heart disease and normal renal function .The relationship between serum 1evels of Cys C and coronary heart disease was evaluated from three aspects :the number of diseased vessels ,the severity of diseased ves‐sels and the CHD Gensini scores .Results The Cys C level in CHD group was significantly higher than that of non‐CHD group [(1 .24 ± 0 .32)mg/L vs .(1 .12 ± 0 .27)mg/L ,P<0 .01] .Serum Cys C was significantly higher in the multi‐vessel disease group than that of the single‐vessel disease group[(1 .31 ± 0 .31)mg/L vs .(1 .20 ± 0 .32)mg/L ,P<0 .01] .Serum Cys C was significantly higher in the severe coronary artery stenosis group than in the mild stenosis group [(1 .29 ± 0 .36)mg/L vs .(1 .16 ± 0 .23)mg/L , P<0 .01] .Cys C was positively correlated with the Gensini scores of coronary arterial lesion (r=0 .195 ,P<0 .01) .Conclusion Cys C levels increased in patients with coronary heart disease and normal renal function .Cys C was positively correlated with the Gensini scores of coronary arterial lesion .Serum Cys C levels has certain predictive value on coronary arterial lesions in patients with CHD .
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Objective To explore the expression of serum cystatin C ( Cys C ) and urinary N-acetyl-beta-D-glucosaminidase ( NAG) in elderly diabetes patients with early renal injury .Methods 127 cases of diabetes were di-vided into the pure diabetic group ,early diabetic nephropathy group ,diabetic nephropathy ,and the other 38 cases of healthy persons as the control group.The serum Cys C,and serum Creatinine(Scr)concentration by automatic bio-chemical analyzer were detected ,urinary NAG activity was detected by colorimetric determinate ,24 hours albumin ex-cretion rate(UAER/24h)was tested.Results The serum Cys C,urinary NAG,Scr,UAER/24h showed an increasing trend in four groups of patients respectively ,the difference was statistically significant (P<0.05 or P<0.01).The se-rum Cys C and urinary NAG showed a positive correlation with Scr and UAER /24 h respectively .The accuracy ,sensi-tivity,specificity of serum Cys C in diagnosis of early diabetic nephropathy group were 86.8%,76.1%,97.8% re-spectively,The accuracy,sensitivity,specificity of NAG in diagnosis of early diabetic nephropathy group were 83.5%, 71.7%,95.6%.Conclusion The serum Cys C and urinary NAG could sensitively reflect early elderly diabetic renal damage,which were the ideal endogenous indicators of glomerular filtration rate (GFR).
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Objective:To discuss the relationship between serum advanced oxidation protein products (AOPP)and cystatin C with the early preeclampsia pregnancy outcome.Methods:Clinical data of 75 patients received treatment and labor at our hospital from 2011 to 2013 was retrospectively analyzed.The control group included 60 normal pregnant women who received prenatal examination in our hospital at the same time.The difference in cystatin C and AOPP level of the patients with preeclampsia and the normal group was compared.The clinical data and the adverse pregnancy outcome of the patients with preeclampsia in different severity and different outcome of pregnancy were compared.Results:A total of 135 patients were retrospective analyzed ,including 75 in observe group and 60 in control group.The SBP level in the patients with preeclampsia is obviously higher than in the normal group .The level of SB,UA,Cr and AOPP in the patients of mild group is obviously lower than in the severe group.The incidence of oligohydramnios , placental abruption,fetal growth restriction and HELLP syndrome in the patients of mild group was obviously lower than in the severe group .The differences were statistically significant.The level of cystatin C,UA,Cr and AOPP in the patients of adverse pregnancy outcome were obviously higher than in the group of good outcome of pregnancy.Conclusion:The cystatin C and AOPP level of the early preeclampsia patients is obviously increased and it has significant correlation with the pregnancy outcome in patients .
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Objective To investigate the prognostic significance of serum cystatin C in multiple myeloma (MM).Methods 160 cases of newly diagnosed MM patients with average age of 61.38 years old.Determine the levels of serum cystatin C,serum creatinine,β 2-microglobulin,lactate dehydrogenase and hemoglobin before the treatment; median follow-up of 38 months,observe the relationship between serum cystatin C with overall survival (OS) and event-free survival (EFS).Results Median serum cystatin C level in 160 MM patients was higher than that in the 80 healthy controls [(0.96 ± 0.32) mg/L vs (0.71 ± 0.16) mg/L,P ＜ 0.000].All the patients in ISS stage were divided into 3 stages.Median serum cystatin C levels significantly increased in higher ISS stages [stage Ⅰ (0.70±0.13) mg/L,stage Ⅱ (0.87±0.16) mg/L,stage Ⅲ(1.23±0.33) mg/L (P ＜ 0.05)],serum cystatin C level was positively correlated with levels of serum creatinine (r =0.669,P ＜ 0.000),β2-microglobulin (r =0.672,P ＜ 0.000).lactate dehydrogenase (r =0.521,P ＜ 0.000),and negatively correlated with hemoglobin levels (r =-0.436,P ＜ 0.000).Using ROC analysis,patients with serum cystatin C levels ＞ 0.95 mg/L had significantly shorter EFS and OS patients with serum cystatin C levels ≤0.95 mg/L (median EFS:30 vs 57 months,P ＜ 0.05; median OS:43 vs 68 months,P ＜ 0.05).Conclusion Serum cystain C is not only a sensitive marker of kidney damage,but also reflects tumor burden and delivers prognostic information in MM.
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BACKGROUND: Accurate renal function measurements are important in the diagnosis and treatment of kidney diseases. In contrast to creatinine, the production of serum cystatin C has been extensively reported to be unaffected by body muscle mass, age, gender, and nutritional status. METHODS: Our study included 37 samples from diabetic chronic kidney disease (CKD) patients for whom serum creatinine tests had been requested and 40 samples from a healthy populations in Dong-A University Hospital between May 2010 and June 2010. The assay precision (i.e., the coefficient of variation) and the reference range of the serum cystatin C test were evaluated. We compared the estimated glomerular filtration rates (GFRs) based on cystatin C with those based on creatinine. Moreover, we investigated the influences of age, gender, weight, and muscle mass on serum creatinine and serum cystatin C. RESULTS: There was a positive correlation between GFR based on creatinine and that based on cystatin C (r=0.79, P<0.0001) among the diabetic CKD patients. Serum creatinine and cystatin C were significantly correlated with body weight and muscle mass, but the strengths of these correlations were greater for serum creatinine. The precision study revealed excellent results for both the high and low controls. The 95% reference interval of cystatin C in the healthy population was 0.371 to 1.236 mg/L. CONCLUSION: Based on these results, we conclude that, despite the strong correlation between serum creatinine and cystatin C, cystatin C is less affected by weight and muscle mass and might represent a better alternative for the assessment of renal function.