Telo Selda, Kuluöztürk Mutlu, Deveci Figen, Kırkıl Gamze, Öner Önsel, Kaman Dilara
Department of Biochemistry, Firat University, Faculty of Medicine, Elazig, Turkey.
Elazığ Education and Research Hospital, Elazig, Turkey.
J Med Biochem. 2018 Dec 1;37(4):434-440. doi: 10.1515/jomb-2017-0064. eCollection 2018 Dec.
The aim of this study was to determine the level of serum cystatin C (CysC) in patients with Chronic Obstructive Pulmonary Disease (COPD) during exacerbation and stable periods and to investigate its potential diagnostic value and the relationship between CysC levels and the pulmonary function test (PFT).
One hundred twenty-six patients with COPD (68 in stable periods, 58 during exacerbation periods) and 50 healthy subjects were included in the study. PFT, body mass index (BMI), white blood cell counts, C-reactive protein (CRP), serum urea and creatinine levels were evaluated in both groups of patients. CysC levels were measured in all participants.
Serum CysC levels were statistically higher in both COPD groups than the control group (p<0.001 for both) although there was no statistically significant difference between COPD groups (p>0.05). CysC levels showed negative correlation with forced expiratory volume in 1 second (FEV) and a positive correlation with C-reactive protein (CRP) levels in patients with stable COPD. There was a positive correlation between serum CysC levels and serum urea, creatinine, CRP levels in patients with COPD exacerbation (r=0.333, p=0.011; r=0.260, p=0.049; r=0.414, p<0.01 respectively). When stable COPD and control groups were evaluated, serum CysC had an area under the curve (AUC) in the receiver operating characteristic (ROC) curve of 0.951 (0.909-0.994 95% CI: p<0.001).
Our results showed that CysC levels increased in both COPD groups. Increased CysC levels may be related with lung function decline and inflammation in COPD patients. In addition, CysC levels may be a potential indicator for the diagnosis of COPD.
本研究旨在测定慢性阻塞性肺疾病（COPD）患者急性加重期和稳定期的血清胱抑素C（CysC）水平，探讨其潜在诊断价值以及CysC水平与肺功能测试（PFT）之间的关系。
本研究纳入了126例COPD患者（稳定期68例，急性加重期58例）和50名健康受试者。对两组患者均评估了PFT、体重指数（BMI）、白细胞计数、C反应蛋白（CRP）、血清尿素和肌酐水平。测定了所有参与者的CysC水平。
两组COPD患者的血清CysC水平均显著高于对照组（两组均p<0.001），但COPD组之间无显著差异（p>0.05）。稳定期COPD患者的CysC水平与第1秒用力呼气量（FEV）呈负相关，与C反应蛋白（CRP）水平呈正相关。COPD急性加重期患者的血清CysC水平与血清尿素、肌酐、CRP水平呈正相关（r分别为0.333，p=0.011；r=0.260，p=0.049；r=0.414，p<0.01）。评估稳定期COPD组和对照组时，血清CysC在接受者操作特征（ROC）曲线中的曲线下面积（AUC）为0.951（0.909 - 0.994，95%CI：p<0.001）。
我们的结果表明，两组COPD患者的CysC水平均升高。CysC水平升高可能与COPD患者的肺功能下降和炎症有关。此外，CysC水平可能是诊断COPD的一个潜在指标。
