Macisaac R J, Tsalamandris C, Thomas M C, Premaratne E, Panagiotopoulos S, Smith T J, Poon A, Jenkins M A, Ratnaike S I, Power D A, Jerums G
Endocrine Centre and the Department of Medicine, Austin Health and University of Melbourne, Heidelberg Repatriation Hospital, Level 2, Centaur Building, Heidelberg West, VIC, 3081, Australia.
Diabetologia. 2006 Jul;49(7):1686-9. doi: 10.1007/s00125-006-0275-7. Epub 2006 May 3.
AIMS/HYPOTHESIS: We compared the predictive performance of a GFR based on serum cystatin C levels with commonly used creatinine-based methods in subjects with diabetes.
SUBJECTS, MATERIALS AND METHODS: In a cross-sectional study of 251 consecutive clinic patients, the mean reference (plasma clearance of (99m)Tc-diethylene-triamine-penta-acetic acid) GFR (iGFR) was 88+/-2 ml min(-1) 1.73 m(-2). A regression equation describing the relationship between iGFR and 1/cystatin C levels was derived from a test population (n=125) to allow for the estimation of GFR by cystatin C (eGFR-cystatin C). The predictive performance of eGFR-cystatin C, the Modification of Diet in Renal Disease 4 variable formula (MDRD-4) and Cockcroft-Gault (C-G) formulas were then compared in a validation population (n=126).
There was no difference in renal function (ml min(-1) 1.73 m(-2)) as measured by iGFR (89.2+/-3.0), eGFR-cystatin C (86.8+/-2.5), MDRD-4 (87.0+/-2.8) or C-G (92.3+/-3.5). All three estimates of renal function had similar precision and accuracy.
CONCLUSIONS/INTERPRETATION: Estimates of GFR based solely on serum cystatin C levels had the same predictive potential when compared with the MDRD-4 and C-G formulas.
目的/假设：我们比较了基于血清胱抑素C水平的肾小球滤过率（GFR）与糖尿病患者常用的基于肌酐的方法的预测性能。
受试者、材料与方法：在一项对251例连续门诊患者的横断面研究中，平均参考（（99m）Tc-二乙三胺五乙酸的血浆清除率）GFR（iGFR）为88±2 ml·min⁻¹·1.73 m⁻²。从一个测试人群（n = 125）中得出了一个描述iGFR与1/胱抑素C水平之间关系的回归方程，以通过胱抑素C估算GFR（eGFR-胱抑素C）。然后在一个验证人群（n = 126）中比较了eGFR-胱抑素C、肾脏病膳食改良4变量公式（MDRD-4）和Cockcroft-Gault（C-G）公式的预测性能。
通过iGFR（89.2±3.0）、eGFR-胱抑素C（86.8±2.5）、MDRD-4（87.0±2.8）或C-G（92.3±3.5）测量的肾功能（ml·min⁻¹·1.73 m⁻²）没有差异。所有三种肾功能估计值的精密度和准确性相似。
结论/解读：与MDRD-4和C-G公式相比，仅基于血清胱抑素C水平的GFR估计值具有相同的预测潜力。
