Serum cystatin C advantageous compared with serum creatinine in the detection of mild but not severe diabetic nephropathy.
| العنوان: | Serum cystatin C advantageous compared with serum creatinine in the detection of mild but not severe diabetic nephropathy. |
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| المؤلفون: | Christensson, Anders, Grubb, Anders, Nilsson, J-A, Norrgren, Kristina, Sterner, Gunnar, Sundkvist, Göran |
| المصدر: | Journal of Internal Medicine. 256(6):510-518 |
| مصطلحات موضوعية: | Adult, Age Factors, Aged, Albuminuria/etiology, Biomarkers/blood, Creatinine/blood, Cystatin C, Cystatins/blood, Diabetes Mellitus, Type 1/blood, Type 2/blood, Diabetic Nephropathies/blood, Female, Glomerular Filtration Rate, Humans, Kidney Function Tests/methods, Male, Middle Aged, Prospective Studies, ROC Curve, Medicin och hälsovetenskap, Klinisk medicin, Endokrinologi och diabetes, Medical and Health Sciences, Clinical Medicine, Endocrinology and Diabetes, Radiologi och bildbehandling, Radiology, Nuclear Medicine and Medical Imaging, Medicinska och farmaceutiska grundvetenskaper, Läkemedelskemi, Basic Medicine, Medicinal Chemistry, Farmakologi och toxikologi, Pharmacology and Toxicology |
| الوصف: | OBJECTIVE: To determine whether serum cystatin C is more accurate than serum creatinine in the detection of diabetic nephropathy, also after adjustment for age.METHODS: Forty-one patients with type 1 and 82 patients with type 2 diabetes were evaluated with serum creatinine, serum cystatin C, and (51)Cr-EDTA clearance (reference method). Cystatin C was measured by a particle-enhanced turbidimetric method and creatinine by an enzymatic method. Statistical estimations were performed both without and with age adjustment created by z-scores for (51)Cr-EDTA clearance, creatinine, and cystatin C. The cut-off levels for glomerular filtration rate (GFR) ((51)Cr-EDTA clearance) were 60 and 80 mL min(-1) 1.73 m(-2), respectively, in absolute values and 80, 90 and 95% CIs, respectively, in age-adjusted values (z-scores).RESULTS: Estimations without age adjustment showed significantly (P = 0.0132) closer correlation for cystatin C (r = 0.817) versus (51)Cr-EDTA clearance as compared with creatinine (r = 0.678). However, when using age-adjusted values, the correlation for cystatin C and creatinine, respectively, versus (51)Cr-EDTA clearance did not differ. When comparing the diagnostic utilities for serum cystatin C versus serum creatinine in manifest renal impairment (GFR < 60 mL min(-1) 1.73 m(-2) or z-scores <-1.28 SD), there were no significant differences between the two markers whether age adjusted or not. However, for diagnosing mild nephropathy (GFR < 80 mL min(-1) 1.73 m(-2) or z-score -0.84 SD), serum cystatin C is significantly more useful.CONCLUSIONS: Serum cystatin C performed better compared with serum creatinine even when measured enzymatically, to detect mild diabetic nephropathy. However, serum creatinine was as efficient as serum cystatin C to detect advanced diabetic nephropathy. |
| وصف الملف: | electronic |
| الوصول الحر: | https://lup.lub.lu.se/record/130735Test https://portal.research.lu.se/files/4443690/624167.pdfTest http://dx.doi.org/10.1111/j.1365-2796.2004.01414.xTest |
| قاعدة البيانات: | SwePub |
| تدمد: | 13652796 |
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| DOI: | 10.1111/j.1365-2796.2004.01414.x |