Zheng Hui, Liu Haidong, Hao Anhua, Zhang Min, Wang Dexin
Department of Clinical Laboratory, Qingdao Fifth People's Hospital.
Department of Gastroenterology, Qingdao Sixth People's Hospital.
Medicine (Baltimore). 2020 Aug 7;99(32):e21551. doi: 10.1097/MD.0000000000021551.
To explore the association between serum cystatin C (Cys-C) and renal damage in patients with chronic hepatitis B.We retrospectively analyzed the clinical data of 425 patients with chronic hepatitis B virus (HBV) infection. Liver stiffness measured by FibroScan was used to diagnosis liver fibrosis. Cys-C levels were detected via latex-enhanced immunoturbidimetric assay.A total of 425 patients were enrolled. Among them, 217 were patients with CHB with an eGFR > 90 mL/min/1.73 m and 208 with an eGFR ≤90 mL/min/1.73 m. Cys-C levels significantly differed in patients with eGFR > 90 mL/min/1.73 m compared with patients with eGFR ≤90 mL/min/1.73 m (0.81 ± 0.05 vs 1.05 ± 0.06 mg/L, P < .001). Moreover, the Cys-C levels were 0.82 ± 0.04 mg/L in patients without liver fibrosis, 0.98 ± 0.05 mg/L in patients with mild liver fibrosis, 1.05 ± 0.08 mg/L in patients with advanced liver fibrosis, and 1.12 ± 0.07 mg/L in patients with liver cirrhosis (P < .001). Multivariate analyses were conducted to explore the independent factors associated with a decreased eGFR. Multivariate analysis suggested that T2DM (P = .032), liver fibrosis (P = .013), and Cys-C level (P = .035) were the independent factors associated with the decreased eGFR in patients with CHB. While age (P = .020) and Cys-C level (P = .001) were the independent factors associated with the decreased eGFR in patients with CHB-related fibrosis.The fibrosis group had significantly higher Cys-C levels than those without fibrosis. Routine monitoring of Cys-C levels is of positive significance in preventing the development of renal impairment of CHB patients.
探讨慢性乙型肝炎患者血清胱抑素C（Cys-C）与肾损伤之间的关联。我们回顾性分析了425例慢性乙型肝炎病毒（HBV）感染患者的临床资料。采用FibroScan测量肝脏硬度来诊断肝纤维化。通过乳胶增强免疫比浊法检测Cys-C水平。共纳入425例患者。其中，217例为慢性乙型肝炎患者，估算肾小球滤过率（eGFR）>90 mL/min/1.73 m²，208例eGFR≤90 mL/min/1.73 m²。与eGFR≤90 mL/min/1.73 m²的患者相比，eGFR>90 mL/min/1.73 m²的患者Cys-C水平有显著差异（0.81±0.05 vs 1.05±0.06 mg/L，P<0.001）。此外，无肝纤维化患者的Cys-C水平为0.82±0.04 mg/L，轻度肝纤维化患者为0.98±0.05 mg/L，重度肝纤维化患者为1.05±0.08 mg/L，肝硬化患者为1.12±0.07 mg/L（P<0.001）。进行多因素分析以探讨与eGFR降低相关的独立因素。多因素分析表明，2型糖尿病（T2DM，P=0.032）、肝纤维化（P=0.013）和Cys-C水平（P=0.035）是慢性乙型肝炎患者eGFR降低的独立相关因素。而年龄（P=0.020）和Cys-C水平（P=0.001）是慢性乙型肝炎相关纤维化患者eGFR降低的独立相关因素。纤维化组的Cys-C水平显著高于无纤维化组。定期监测Cys-C水平对预防慢性乙型肝炎患者肾功能损害的发生具有积极意义。
