OBJECTIVETo study the association between serum cystatin C level and blood pressure.

METHODSWe conducted a cross-sectional study of 912 subjects randomly sampled from a cohort visiting for routine physical examinations. The epidemiological data were obtained using questionnaires and from the database of physical examination results. Pearson analysis and multiple stepwise regression analysis were used to analyze the relationship between blood pressure and cystatin C.

RESULTSThe levels of serum cystatin C differed significantly among the normotensive, prehypertensive, and hypertensive subjects (P<0.05). Pearson analysis revealed that regardless of gender, serum cystatin C was positively correlated with SBP, DBP, MAP, BMI, TC, TG, LDL-C, UA and BUN (P<0.05). With MAP, SBP and DBP as dependent variables, multiple stepwise regression analysis of the factors affecting blood pressure indicated that cystatin C had the strongest effect on SBP and MAP (P<0.05) but did not significantly affect DBP (P>0.05).

CONCLUSIONSerum cystatin C level is significantly correlated with SBP and MAP and can be used as a biomarker for alert of hypertension.

Biomarkers ; blood ; Blood Pressure ; Cross-Sectional Studies ; Cystatin C ; blood ; Humans ; Hypertension ; blood

Biomarkers ; Cystatin C ; blood ; Early Diagnosis ; Hepatorenal Syndrome ; diagnosis ; Humans ; Renal Artery

OBJECTIVETo compare plasma asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, and cystatin C levels in patients with or without coronary artery disease (CAD).

METHODSWe recruited 87 CAD patients (39 with acute myocardial infarction and 48 with unstable angina pectoris) and 51 non-CAD controls. Plasma ADMA was measured by HPLC, cystatin C by particle-enhanced immunonephelometric assay (N Latex cystatin C, Dade Behring) with nephelometer (BNII, Dade Behring). CAD patients were further divided into low cystatin C group (< 1.0 mg/L, 36 cases) and high cystatin C group (> 1.0 mg/L, 51 cases).

RESULTS(1) The plasma levels of ADMA [(0.47 ± 0.15) µmol/L vs. (0.37 ± 0.15) µmol/L], SDMA [(0.39 ± 0.19) µmol/L vs. (0.28 ± 0.12) µmol/L] and cystatin C [(1.16 ± 0.32) mg/L vs. (0.73 ± 0.16) mg/L] were significantly higher in CAD patients than in controls (all P < 0.05). The plasma L-Arg was significantly lower in CAD patients than in controls [(59.4 ± 19.4) µmol/L vs. (83.7 ± 19.6) µmol/L, P < 0.05]. (2) Plasma ADMA was similar in CAD patients with low cystatin C level and controls [(0.42 ± 0.12) µmol/L vs. (0.39 ± 0.15) µmol/L, P = 0.251] and Plasma ADMA was significantly higher in CAD patients with high cystatin C level than in controls [(0.50 ± 0.17) µmol/L vs. (0.39 ± 0.15) µmol/L, P < 0.05].

CONCLUSIONADMA levels were significantly increased only in CAD patients with elevated cystatin C levels but not in CAD patients with normal renal function. The reported relationship between coronary heart disease and ADMA may not be direct, but could be secondary due to reduced renal function.

Aged ; Arginine ; analogs & derivatives ; blood ; Case-Control Studies ; Coronary Disease ; blood ; Cystatin C ; blood ; Female ; Humans ; Male ; Middle Aged

OBJECTIVE: To explore the relationship between serum cystatin-C (Cys-c) levels and vibrating perception threshold (VPT) in patients with Type 2 diabetes mellitus (T2DM).
 METHODS: According to the symptoms, signs and results of lab examination, a total of 352 patients with T2DM were divided into a diabetic peripheral neuropathy group (DPN group, n=107) and a non-diabetic peripheral neuropathy group (NDPN group, n=245). Serum Cys-c levels were measured by radioimmunoassay method. The relationship between serum Cys-c levels and VPT, estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (ACR), glucose and blood pressure and other parameters were also analyzed by correlation and multiple regression analysis. All T2DM patients were divided into a high Cys-c levels group (n=89) and a low Cys-c levels group (n=263) according to the upper quartile of Cys-c, and the incidence of DPN and VPT levels in each group were compared. Risk factors of DPN in T2DM patients were analyzed by binary logistic regression analysis and receiver operating characteristic (ROC) curve was used to identify the optimal cutoff of serum Cys-c levels for predicting DPN in patients with T2DM.
 RESULTS: Serum Cys-c levels were significantly higher in the DPN group than that in the NDPN group [(1.04±0.43) vs (0.80±0.25) mg/L, P<0.01]. Correlation analysis showed that serum Cys-c levels were positively correlated with age, body mass index (BMI), serum creatinine (SCr), blood urea nitrogen (BUN), ACR, VPT, pulse pressure (PP), white blood cell( WBC) , red cell distribution width (RDW), hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) (r=0.410, 0.115, 0.613, 0.433, 0.291, 0.300, 0.156, 0.129, 0.282, 0.314, 0.236, respectively, P<0.05 or P<0.01); and negatively correlated with diastolic blood pressure (DBP), eGFR and indirect bilirubin (IBIL) (r=-0.135, -0.647, -0.114, respectively, P<0.05 or P<0.01). Serum Cys-c levels in T2DM patients were positively correlated with VPT after adjusting for gender, age, BMI, ACR and eGFR (r=0.235, P<0.01). Multiple regression analysis revealed that VPT, age, SCr, eGFR, PP, ACR and HbA1C were independent related factors affecting serum Cys-c levels in T2DM patients. Compared with those in the low Cys-c levels group, the prevalence rate and VPT value was increased in the high Cys-c levels group (all P<0.01). Binary logistic regression analysis found that age, Cys-c and HbA1C were independent risk factors for predicting DPN in T2DM patients (all P<0.01). ROC curve analysis revealed that the optimal cutoff of Cys-c to predict DPN in T2DM patients was 0.996 mg/L, the sensitivity was 43.9%, the specificity was 83.7%, and the area under curve was 0.663.
 CONCLUSION Serum Cys-c levels are well correlated with VPT in patients with T2DM. When the serum Cys-c levels>0.996 mg/L, the predicts have high risk of DPN in T2DM patients, which might be related to diabetic nephropathy, oxidative stress and inflammatory reaction induced by advanced age, hyperglycemia and hypertension.
Cystatin C ; blood ; Diabetes Mellitus, Type 2 ; blood ; Diabetic Neuropathies ; blood ; Humans ; Incidence ; Perception ; physiology ; Prevalence ; Risk Factors ; Vibration

OBJECTIVE: To investigate the relationship between metabolic syndrome (MetS) and cystatin C in people undergoing healthy examination.
 METHODS: A total of 6 783 subjects were analyzed. They were divided into MetS group (n=1 578), metabolic disturbance (MetD) group (n=3 617) and healthy control (HC) group (n=1 588). The general information, anthropometry, blood sample and urine sample were collected for all the subjects. Multiple logistic regression analysis was used to identify risk factors for MetS and analysis of covariance was used to investigate the correlation between the number of metabolic disturbance components and cystatin C.
 RESULTS: Compared with the HC group, the level of cystatin C significantly increased in MetS and MetD group; compared with MetD group, the level of cystatin C significantly increased in MetS group (P<0.05). After correction by age, sex, smoking, alcohol intake, menopause, waist circumference, body mass index, blood pressure, plasma cholesterol, fasting plasma glucose, estimated glomerular filtration rate, serum uric acid, microalbuminria, high sensitive C-reaction protein and homocysteine, the cystatin C was closely related with MetS (OR=1.951, 95% CI 1.265-3.009, P<0.05). Similarly, the OR value of risk with MetS was increased with the quartile of cystatin C level (P<0.05). In addition, with the increase in metabolic disturbance components, the level of cystatin C was also increased significantly (P<0.01).
 CONCLUSION Serum cystatin C in our study was significantly associated with MetS. Moreover, the level of cystatin C may be correlated with severity of MetD.
Blood Pressure ; Body Mass Index ; Case-Control Studies ; Cystatin C ; blood ; Humans ; Metabolic Syndrome ; blood ; Risk Factors ; Waist Circumference

The glomerular filtration rate (GFR) is an important index of renal function with advantages of accurate, sensitive, stable, repetitive and accurate measurement of renal functions. The GFR is mainly determined in the clear rate of radioisotope markers (99m)Tc-DTPA, the process of which is complicated, long time-taking, high cost, and radioactively injuring. Recently, the methods using other renal function parameters measured easily to create the mathematic models and to estimate GFR are being investigated in the world. In this paper, for the renal function data of the Chinese, the efficiency in the three existing GFR formulas has been optimized with multi-function optimization techniques and the accuracy of the computation has been improved. Then the BP neural network technology is used for establishing a new GFR formula, which is a simpler form and obtains higher precision result than the formulas existed. The rmse and P30 of the new formula are better than those of the old ones.
Algorithms ; Creatinine ; blood ; Cystatin C ; blood ; Glomerular Filtration Rate ; Humans ; Models, Theoretical ; Neural Networks (Computer) ; Technetium Tc 99m Pentetate

OBJECTIVETo study the relationship of cystatin C (CysC), fibrinogen (Fbg), and 24-hour urinary protein with renal pathological grade in children with Henoch-Schönlein purpura nephritis (HSPN), and to explore their values.

METHODSThe clinical data of 48 children diagnosed with HSPN by renal biopsy from January 2011 to January 2015 were reviewed. According to renal pathological grading, in the 48 children with HSPN, 12 had stage IIa or lower, 12 stage IIb, 17 stage IIIa, and 7 stage IIIb or higher. The latex-enhanced immunoturbidimetric assay, turbidimetric measurement, and end-point method were used to determine the levels of serum CysC, Fbg, and 24-hour urinary protein, respectively. Pearson and Spearman correlation analyses were used to test the correlations between the indices and between the indices and renal pathological grade.

RESULTSThere were significant differences in the levels of serum CysC, Fbg, and 24-hour urinary protein between patients with different pathological grades (P<0.05). The level of each index increased with increasing pathological grade (P<0.05). In the 48 children with HSPN, the level of 24-hour urine protein was positively correlated with the levels of serum CysC (r=0.51, P<0.05) and Fbg (r=0.63, P<0.05). The level of Fbg was positively correlated with that of serum CysC (r=0.55, P<0.05). The levels of CysC, Fbg, and 24-hour urinary protein were all positively correlated with renal pathological grade (r=0.66, 0.64 and 0.68; respectively, P<0.05).

CONCLUSIONSThe levels of CysC, Fbg, and 24-hour urine protein can reflect the severity of renal injury, providing satisfactory prediction of the severity of renal injury in children with HSPN.

Child ; Cystatin C ; blood ; Female ; Fibrinogen ; analysis ; Humans ; Kidney ; pathology ; Male ; Nephritis ; pathology ; Proteinuria ; pathology ; Purpura, Schoenlein-Henoch ; blood ; pathology

OBJECTIVETo study the value of serum Cystatin C (Cyst C) in the evaluation of glomerular filtration function in children with viral encephalitis.

METHODSSerum levels of Cyst C, urea nitrogen (BUN) and creatinine (Cr) were measured in 92 children with viral encephalitis and in 50 healthy children as a control group. According to glomerular filtration rate (GFR), the encephalitis group was subdivided into normal renal function, renal insufficiency in the compensatory or decompensatory stage, and renal failure /end-stage groups.

RESULTSSerum levels of Cyst C, BUN and Cr in the encephalitis group increased and GFR decreased significantly compared with those in the control group (P<0.01). With the decline of renal function, GFR decreased and serum levels of Cyst C, BUN and Cr increased gradually. Serum levels of Cyst C and GFR were significantly different among the encephaitis subgroups (P<0.01). For serum levels of BUN and Cr, there were significant differences among the subgroups except between the normal renal function and the compensatory renal insufficiency groups. Serum Cyst C level was positively correlated with serum BUN and Cr levels, and negatively correlated with GFR.

CONCLUSIONSThe children with viral encephalitis have different degrees of renal impairments. Cyst C appears to be superior to BUN and Cr as a marker for the evaluation of glomerular filtration function. Measurement of serum Cyst C levels is very valuable in renal function monitoring in children with viral encephalitis.

Child ; Child, Preschool ; Cystatin C ; blood ; Encephalitis, Viral ; blood ; physiopathology ; Female ; Glomerular Filtration Rate ; Humans ; Infant ; Male ; Renal Insufficiency ; diagnosis

Objective To investigate the relationship between serum cystatin C(CysC)level and vascular complications in type 2 diabetes mellitus(T2DM)patients with normal renal function. Methods Totally 218 T2DM patients who were treated in the Department of Endocrinology,Affiliated Hospital of Chengde Medical College from January 2017 to May 2018 were enrolled.All subjects were divided into four groups based on the quartiles of serum CysC levels:G1 group:≤ 0.56 mg/L,58 cases;G2 group:0.57-0.73 mg/L,52 cases;G3 group:0.74-1.11 mg/L,56 cases;G4 group:≥ 1.12 mg/L,52 cases.The general data,biochemical indicators,glycated albumin,hemoglobin A
Biomarkers/blood* ; Cardiovascular Diseases/complications* ; Cystatin C/blood* ; Diabetes Mellitus, Type 2/complications* ; Humans ; Kidney ; Risk Factors

OBJECTIVETo explore the dynamic variation rule of kidney injury makers of molecule 1 (KIM-1), Cystatinc (Cys-C), Blood urea nitrogen (BUN) and Creatinine (Cr) in kidney injury in rats with acute paraquat poisoning.

METHODSHealthy adult rats were randomly divided into control group (normal saline solution) and exposure group (2% paraquat solution 40 mg/kg), and 90 in each group. Six rats in each group were randomly sacrificed at one, one point five, two, three, six, twelve, twenty four, seventy two or one hundred and sixty eight hours after different administration, abdominal aortic blood and the kidney tissue were collected. The concenstrations of kidney injury makers of molecule 1 (KIM-1), cystatinc (Cys-C), blood urea nitrogen (BUN) and creatinine (Cr) were determined by ELASA. The concenstrations of paraquat were determined by HPLC. Pathological changes of kidney tissue that stained by HE were axamined by optical microscopy. The cell apoptosis in kidney tissue were analyzed by TUNEL assay. The ptotein expression of KIM-1 was determined by immunohistochemistry.

RESULTSSerum levels of KIM-1 were significantly increased in exposure group as compared with control group at two, three, six, twelve, twenty four, seventy two or one hundred and sixty eight hours, and the peak level was at twenty four hours, and there was a statistical significance between control group and exposure group (P < 0.01). Serum levels of Cys-C were significantly increased in exposure group as compared with control group at six, twelve, twenty four, seventy two or one hundred and sixty eight hours, the peak level was at twenty four hours, and there was a statistical significance between control group and exposure group (P < 0.01). Serum levels of BUN were significantly increased in exposure group as compared with control group at twelve, twenty four, seventy two or one hundred and sixty eight hours, and the peak level was at seventy two hours, and there was a statistical significance between control group and exposure group (P < 0.01). Compared with control group, there was mild tubular epithelial cells edema in exposure group of three hours, serious epithelial cells edema and few slightly increased glomeruli in exposure group of six hours, severe epithelial cells swelling, tube formation, and interstitial lesions including edema, congestionin and increased inflammatory cell infiltration in exposure group of twelve hours, these pathologic changes gradually reached the peak at twenty four hours, the pathologic injury score was 5.56 ± 0.0349 (P < 0.01), and then the pathological lesion was more palliative. Apoptosis rate of kidney tissue were significantly increased in exposure group as compared with control group at three, six, twelve, twenty four, seventy two or one hundred and sixty eight hours, and the peak level was at twenty four hours, and there was a statistical significance between control group and exposure group (P < 0.01). The immunohistochemical assay indicated that KIM-1 of control group were weakly positive expressed in tubular epithelial cell membrane, but the positive expression of KIM-1 were slightly increased in exposure group of two hours, the.immunohistochemistry score was 5.47 ± 0.1033 (P < 0.05), the positive expression of KIM-1 were gradually increased in exposure group of three, six and twelve hours, it reached peak at twenty four hours, the.immunohistochemistry score was 11.73 ± 0.4676 (P < 0.01), then the positive expression of KIM-1 decreased, but there was still positive expression at one hundred and sixty eight hours.

CONCLUSIONSerum levels of KIM-1 and Cys-C were significantly increased in the kidney injury in rats with acute paraquat poisoning in early stage, earlier than the changes of BUN and Cr. KIM-1 had relation with apoptosis rate. Cys-C had relation with pathological lesion changes.

Animals ; Blood Urea Nitrogen ; Creatinine ; blood ; Cystatin C ; blood ; Immunohistochemistry ; Kidney ; drug effects ; pathology ; Membrane Glycoproteins ; blood ; Paraquat ; poisoning ; Rats ; Rats, Sprague-Dawley