Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103, Leipzig, Germany.
LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103, Leipzig, Germany.
Pediatr Nephrol. 2022 Feb;37(2):423-432. doi: 10.1007/s00467-021-05209-2. Epub 2021 Aug 25.
The cystatin C (CysC) serum level is a marker of glomerular filtration rate and depends on age, gender, and pubertal stage. We hypothesize that CysC might overall reflect energy homeostasis and be regulated by components of the endocrine system and metabolites in pubertal adolescents.
Serum CysC levels and further possible effector parameters in 5355 fasting, morning venous blood samples from 2035 healthy participants of the LIFE Child cohort study (age 8 to 18 years) were analyzed. Recruitment started in 2011, with probands followed up once a year. Linear univariate and stepwise multivariate regression analyses were performed.
Annual growth rate, serum levels of thyroid hormones, parathyroid hormone, insulin-like growth factor 1, hemoglobin A1c (HbA1c), uric acid, and alkaline phosphatase show relevant and significant associations with CysC serum concentrations (p <0.001). Furthermore, male probands' CysC correlated with the body mass index and testosterone among other sexual hormones. Multivariate analyses revealed that uric acid and HbA1c are associated variables of CysC independent from gender (p <0.001). In males, alkaline phosphatase (p <0.001) is additionally significantly associated with CysC. Thyroid hormones show significant correlations only in multivariate analyses in females (p <0.001).
The described associations strongly suggest an impact of children's metabolism on CysC serum levels. These alterations need to be considered in kidney diagnostics using CysC in adolescents. Additionally, further studies are needed on CysC in children.
半胱氨酸蛋白酶抑制剂 C（CysC）血清水平是肾小球滤过率的标志物，取决于年龄、性别和青春期阶段。我们假设 CysC 可能总体上反映能量稳态，并受内分泌系统成分和青春期代谢产物的调节。
分析了来自 LIFE Child 队列研究的 5355 例禁食、清晨静脉血样的血清 CysC 水平和其他可能的效应参数，该研究共纳入 2035 例健康参与者（年龄 8 至 18 岁）。招募工作于 2011 年开始，对先证者进行每年一次的随访。进行了线性单变量和逐步多变量回归分析。
年度生长率、甲状腺激素、甲状旁腺激素、胰岛素样生长因子 1、糖化血红蛋白（HbA1c）、尿酸和碱性磷酸酶的血清水平与 CysC 血清浓度呈显著相关（p <0.001）。此外，男性先证者的 CysC 与体重指数和其他性激素中的睾酮相关。多变量分析显示，尿酸和 HbA1c 是独立于性别与 CysC 相关的变量（p <0.001）。在男性中，碱性磷酸酶（p <0.001）也与 CysC 显著相关。只有在女性的多变量分析中，甲状腺激素才显示出显著相关性（p <0.001）。
所描述的相关性强烈表明儿童代谢对 CysC 血清水平有影响。在使用 CysC 进行青少年肾脏诊断时，需要考虑这些变化。此外，还需要对儿童的 CysC 进行进一步研究。
