Suzuki Yoshitake, Matsushita Kazuyuki, Seimiya Masanori, Yoshida Toshihiko, Sawabe Yuji, Ogawa Makoto, Nomura Fumio
Department of Laboratory Medicine, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan.
Department of Laboratory Medicine, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan; Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Clin Chim Acta. 2015 Dec 7;451(Pt B):316-22. doi: 10.1016/j.cca.2015.10.018. Epub 2015 Oct 21.
Estimated glomerular filtration rate (eGFR) is clinically valuable for evaluating renal function. Recently, serum cystatin C (sCysC) measurement has been standardized and has demonstrated utility as a novel indicator of renal function. Thyroid hormone is known to affect serum creatinine (sCr) and sCysC, however, the clinical significance of post-treatment renal function evaluation is yet to be completely elucidated. This study examined the effects of thyroid hormones on eGFR by sCr (eGFRCr), and standardized sCysC (eGFRCysC) in patients with Japanese Graves' disease (GD).
Serum samples were obtained from 113 outpatients with GD. Following pharmacotherapy, 41 of the 113 outpatients with GD achieved remission. Renal function was evaluated by eGFRCr and eGFRCysC. Reference method used Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations.
eGFRCr levels significantly increased whereas eGFRCysC levels significantly decreased with elevated FT3 and FT4 levels in patients with GD. In the remission group, eGFRCr levels significantly decreased and eGFRCysC levels significantly increased. No significant differences between eGFRCr and eGFRCysC levels were observed. Furthermore, CKD-EPI equations show a similar trend and eGFRCr-CysC levels were no significant differences regardless of before and after treatment.
Renal function evaluation by eGFRCr and eGFRCysC had clinical utility in post-treatment euthyroidism.
估计肾小球滤过率（eGFR）在评估肾功能方面具有临床价值。近年来，血清胱抑素C（sCysC）检测已标准化，并已证明其作为肾功能新指标的效用。已知甲状腺激素会影响血清肌酐（sCr）和sCysC，然而，治疗后肾功能评估的临床意义尚未完全阐明。本研究探讨了甲状腺激素对日本Graves病（GD）患者基于sCr的eGFR（eGFRCr）和标准化sCysC（eGFRCysC）的影响。
从113例GD门诊患者中采集血清样本。药物治疗后，113例GD门诊患者中有41例实现缓解。通过eGFRCr和eGFRCysC评估肾功能。参考方法采用慢性肾脏病流行病学协作组（CKD-EPI）方程。
GD患者中，随着FT3和FT4水平升高，eGFRCr水平显著升高，而eGFRCysC水平显著降低。在缓解组中，eGFRCr水平显著降低，eGFRCysC水平显著升高。eGFRCr和eGFRCysC水平之间未观察到显著差异。此外，CKD-EPI方程显示出类似趋势，无论治疗前后，eGFRCr-CysC水平均无显著差异。
通过eGFRCr和eGFRCysC评估肾功能在治疗后甲状腺功能正常状态下具有临床效用。
