生长激素对胱抑素C的影响。
Impact of Growth Hormone on Cystatin C.
作者信息
Sze Lisa, Bernays René L, Zwimpfer Cornelia, Wiesli Peter, Brändle Michael, Schmid Christoph
机构信息
Division of Endocrinology and Diabetes, Kantonsspital, St. Gallen, Frauenfeld, Switzerland ; Division of Endocrinology and Diabetes, Kantonsspital, St. Gallen, Frauenfeld, Switzerland.
Department of Neurosurgery, University Hospital, Frauenfeld, Switzerland ; Department of Neurosurgery, Clinic Hirslanden, Zurich, Frauenfeld, Switzerland.
出版信息
Nephron Extra. 2013 Nov 20;3(1):118-124. doi: 10.1159/000356464. eCollection 2013.
BACKGROUND
Cystatin C (CysC) is an alternative marker to creatinine for estimation of the glomerular filtration rate (GFR). Hormones such as thyroid hormones and glucocorticoids are known to have an impact on CysC. In this study, we examined the effect of growth hormone (GH) on CysC in patients with acromegaly undergoing transsphenoidal surgery.
METHODS
Creatinine, CysC, GH and insulin-like growth factor-1 (IGF-1) were determined in 24 patients with acromegaly before and following transsphenoidal surgery. Estimated GFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration formula.
RESULTS
In all patients, surgical debulking resulted in decreased clinical disease activity and declining GH/IGF-1 levels. Postoperatively, biochemical cure was documented in 20 out of 24 patients. Creatinine levels (mean ± SEM) increased from 72 ± 3 to 80 ± 3 µmol/l (p = 0.0004) and concurrently, estimated GFR decreased from 99 ± 3 to 91 ± 3 ml/min (p = 0.0008). In contrast to creatinine, CysC levels decreased from 0.72 ± 0.02 to 0.68 ± 0.02 mg/l (p = 0.0008).
CONCLUSIONS
Our study provides strong evidence for discordant effects of GH on creatinine and CysC in patients with acromegaly undergoing transsphenoidal surgery, thus identifying another hormone that influences CysC independent of renal function.
背景
胱抑素C（CysC）是一种用于估算肾小球滤过率（GFR）的肌酐替代标志物。已知甲状腺激素和糖皮质激素等激素会对CysC产生影响。在本研究中，我们检测了生长激素（GH）对接受经蝶窦手术的肢端肥大症患者CysC的影响。
方法
对24例肢端肥大症患者在经蝶窦手术前后测定肌酐、CysC、GH和胰岛素样生长因子-1（IGF-1）。使用慢性肾脏病流行病学协作组公式计算估算的GFR。
结果
所有患者手术减瘤后临床疾病活动度降低，GH/IGF-1水平下降。术后，24例患者中有20例实现生化治愈。肌酐水平（均值±标准误）从72±3 μmol/L升至80±3 μmol/L（p = 0.0004），同时，估算的GFR从99±3 ml/min降至91±3 ml/min（p = 0.0008）。与肌酐不同，CysC水平从0.72±0.02 mg/L降至0.68±0.02 mg/L（p = 0.0008）。
结论
我们的研究为接受经蝶窦手术的肢端肥大症患者中GH对肌酐和CysC的不同影响提供了有力证据，从而确定了另一种独立于肾功能影响CysC的激素。
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