Salgado João Victor, França Ana Karina, Cabral Nayra Anielly, Lages Joyce, Ribeiro Valdinar Sousa, Santos Alcione Miranda, Salgado Bernardete Jorge
Kidney Disease Prevention Centre, Universidade Federal do Maranhão, São Luís, MA, Brazil.
Rev Assoc Med Bras (1992). 2013 Jan-Feb;59(1):21-7. doi: 10.1590/s0104-42302013000100007.
To investigate the clinical usefulness of serum cystatin C (Scys) and cystatin C-based equations for the screening of chronic kidney disease in primary hypertensive patients, and correlate these markers with risk factors for cardiovascular disease.
A cross-sectional study was performed in 199 middle-aged adults at a basic health unit. Kidney function assessment included measurements of serum creatinine (Scr) and Scys levels, 24-hour microalbuminuria (MA), as well as glomerular filtration rate (GFR) through Larsson and Modification of Diet in Renal Disease (MDRD) study equations. Bland- Altman plot analysis was used to calculate the agreement between equations.
High levels of Scys were found in 22% of the patients, even with normal values of GFR estimated by MDRD study equation. Systolic blood pressure and MA correlated better with Scys than Scr, but there was no correlation between Scys and diastolic blood pressure. Gender, age > 60 years, MA, and uric acid were significantly associated with high Scys levels. After multivariate analysis, only age > 60 yrs (RR = 6.4; p < 0.001) and male gender (RR = 3.0; p = 0.006) remained associated with high Scys levels.
Cystatin C can be used as a screening marker both for detecting mild declines of renal function and for preventing the risk of cardiovascular events in hypertensive subjects with presumably normal renal function.
探讨血清胱抑素C（Scys）及基于胱抑素C的公式在原发性高血压患者慢性肾脏病筛查中的临床应用价值，并将这些标志物与心血管疾病风险因素相关联。
在一个基层卫生单位对199名中年成年人进行了一项横断面研究。肾功能评估包括测定血清肌酐（Scr）和Scys水平、24小时微量白蛋白尿（MA），以及通过拉尔森公式和肾脏病饮食改良（MDRD）研究公式计算的肾小球滤过率（GFR）。采用布兰德-奥特曼图分析来计算各公式之间的一致性。
22%的患者Scys水平较高，即便其GFR通过MDRD研究公式估算为正常。收缩压和MA与Scys的相关性比与Scr的更好，但Scys与舒张压之间无相关性。性别、年龄>60岁、MA和尿酸与Scys高水平显著相关。多因素分析后，仅年龄>60岁（RR = 6.4；p < 0.001）和男性（RR = 3.0；p = 0.006）仍与Scys高水平相关。
胱抑素C可作为一种筛查标志物，用于检测肾功能的轻度下降以及预防肾功能可能正常的高血压患者发生心血管事件的风险。
