Marwyne M N Norli, Loo C Y, Halim A G, Norella K, Sulaiman T, Zaleha M I
Faculty of Medicine, University Kebangsaan Malaysia.
Med J Malaysia. 2011 Oct;66(4):313-7.
Obesity and overweight are strong independent risk factors for chronic kidney disease (CKD). Using serum creatinine-based estimated glomerular filtration rate (eGFR) equations in these subjects may be inaccurate. On the other hand, cystatin C-based eGFR equations may overestimate CKD prevalence as recent findings suggest an association of cystatin C with obesity. The objective of this study was to assess the accuracy of a cystatin C-based eGFR equation compared to two creatinine -based eGFR equations in overweight and obese subjects.
This was a prospective cross-sectional study which recruited healthy volunteers aged 18-55 years with a body mass index (BMI) > or = 23kg/m(2) (Asia Pacific Guidelines). Their renal profiles, serum cystatin C and 99m technetium diethylene triamine pentacetic acid (99)mTc-DTPA) scans were performed on the same day. The correlations and accuracy of the creatinine-based and cystatin C-based eGFR equations with the (99)mTc-DTPA GFR were determined.
One hundred and one subjects with a median age of 30.0 (27.0-43.5) years and mean BMI of 28.7 +/- 4.5 kg/m(2) were recruited. The cystatin C-based eGFR equation showed the best correlation with the (99)mTc-DTPA GFR (r = 0.526, p = 0.001) and was more accurate in measuring abnormal GFR compared to the creatinine-based eGFR equations.
Our study showed that the cystatin C-based eGFR equation was more accurate, sensitive and specific in overweight and obese subjects compared to the creatinine-based eGFR equations.
肥胖和超重是慢性肾脏病（CKD）的重要独立危险因素。在这些人群中使用基于血清肌酐的估计肾小球滤过率（eGFR）方程可能不准确。另一方面，基于胱抑素C的eGFR方程可能高估CKD患病率，因为最近的研究结果表明胱抑素C与肥胖有关。本研究的目的是评估在超重和肥胖人群中，与两个基于肌酐的eGFR方程相比，基于胱抑素C的eGFR方程的准确性。
这是一项前瞻性横断面研究，招募了年龄在18 - 55岁、体重指数（BMI）≥23kg/m²（亚太地区指南）的健康志愿者。在同一天对他们进行肾脏检查、血清胱抑素C检测和99m锝二乙三胺五乙酸（99mTc-DTPA）扫描。确定基于肌酐和基于胱抑素C的eGFR方程与99mTc-DTPA肾小球滤过率（GFR）之间的相关性和准确性。
招募了101名受试者，中位年龄为30.0（27.0 - 43.5）岁，平均BMI为28.7±4.5kg/m²。基于胱抑素C的eGFR方程与99mTc-DTPA GFR显示出最佳相关性（r = 0.526，p = 0.001），并且与基于肌酐的eGFR方程相比，在测量异常GFR方面更准确。
我们的研究表明，与基于肌酐的eGFR方程相比，基于胱抑素C的eGFR方程在超重和肥胖人群中更准确、敏感和特异。
