Wiesli Peter, Schwegler Beat, Spinas Giatgen A, Schmid Christoph
Department of Internal Medicine, University Hospital of Zurich, CH-8091 Zurich, Switzerland.
Clin Chim Acta. 2003 Dec;338(1-2):87-90. doi: 10.1016/j.cccn.2003.07.022.
Serum cystatin C (CysC) is a novel marker for kidney function. The impact of mild thyroid dysfunction on CysC has never been investigated.
CysC was determined at the time of diagnosis of subclinical hypo- and hyperthyroidism, and when TSH returned into the normal range in 40 consecutive patients with mild thyroid dysfunction.
Twenty-six patients with subclinical hypothyroidism and 14 patients with subclinical hyperthyroidism were included. In patients with subclinical hypothyroidism median (range) TSH was 7.8 (4.3-26.7) mU/l (reference 0.27-4.2) at diagnosis and decreased to 2.3 (0.36-4.0) mU/l following treatment with levothyroxine. Mean (+/-S.D.) CysC increased from 0.88+/-0.23 mg/l (reference 0.63-1.33) in the hypothyroid state to 1.01+/-0.21 mg/l when TSH normalized (p<0.001). In patients with subclinical hyperthyroidism, median TSH at diagnosis was 0.08 (0.001-0.26) mU/l and increased to 1.6 (0.28-4.0) mU/l in the euthyroid state. CysC declined from 1.04+/-0.29 mg/l at diagnosis of subclinical hyperthyroidism to 0.91+/-0.25 mg/l when TSH normalized (p<0.05).
Mild thyroid dysfunction significantly alters CysC levels. Therefore, thyroid function has to be considered when CysC is used as a marker of kidney function.
血清胱抑素C（CysC）是一种新型肾功能标志物。轻度甲状腺功能障碍对CysC的影响从未被研究过。
对40例轻度甲状腺功能障碍的连续患者，在诊断亚临床甲状腺功能减退和亢进时以及促甲状腺激素（TSH）恢复正常范围时测定CysC。
纳入26例亚临床甲状腺功能减退患者和14例亚临床甲状腺功能亢进患者。亚临床甲状腺功能减退患者诊断时TSH中位数（范围）为7.8（4.3 - 26.7）mU/L（参考值0.27 - 4.2），左甲状腺素治疗后降至2.3（0.36 - 4.0）mU/L。平均（±标准差）CysC从甲状腺功能减退状态下的0.88±0.23mg/L（参考值0.63 - 1.33）升高至TSH正常时的1.01±0.21mg/L（p<0.001）。亚临床甲状腺功能亢进患者诊断时TSH中位数为0.08（0.001 - 0.26）mU/L，甲状腺功能正常状态时升至1.6（0.28 - 4.0）mU/L。CysC从亚临床甲状腺功能亢进诊断时的1.04±0.29mg/L降至TSH正常时的0.91±0.25mg/L（p<0.05）。
轻度甲状腺功能障碍显著改变CysC水平。因此，当将CysC用作肾功能标志物时必须考虑甲状腺功能。
