Koerbel Kimberly, Yalachkov Yavor, Rotter Tabea, Schaller-Paule Martin A, Schaefer Jan Hendrik, Friedauer Lucie, Jakob Jasmin, Steffen Falk, Bittner Stefan, Foerch Christian, Maiworm Michelle
Department of Neurology, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany.
Practice for Neurology and Psychiatry Eltville, 65343 Eltville am Rhein, Germany.
Int J Mol Sci. 2025 Jan 17;26(2):748. doi: 10.3390/ijms26020748.
Impaired renal function can influence biomarker levels through mechanisms involving blood-brain barrier integrity and clearance pathways; however, the impact of variations within normal renal function remains unclear. The main aim of this study was to determine whether adjustment for the specific level of renal function is necessary when renal function remains within physiological levels. We studied n = 183 patients (NID n = 122; other neurological diseases n = 39; somatoform controls n = 22) who underwent lumbar puncture at University Hospital Frankfurt. Serum and cerebrospinal fluid (CSF) levels of neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), total tau protein (tTAU), and ubiquitin C-terminal hydrolase-L1 (UCHL1) were measured using the single molecule array (SIMOA) technique. Estimated glomerular filtration rate (eGFR) correlated negatively with CSF GFAP (r = -0.217, = 0.004) and serum NfL (r = -0.164, = 0.032). Patients with impaired renal function exhibited higher CSF NfL ( = 0.036) and CSF GFAP ( = 0.026) levels. However, these findings did not remain significant after adjusting for BMI and age. Importantly, in patients with normal renal function, no significant correlations with eGFR and biomarker levels were observed after adjustment. Our findings indicate that serum and CSF concentrations of NfL, GFAP, tTAU, and UCHL1 are not significantly affected by fluctuations in physiological kidney function but emphasize the importance of considering comorbidities in impaired renal function when interpreting biomarker levels.
肾功能受损可通过涉及血脑屏障完整性和清除途径的机制影响生物标志物水平；然而，正常肾功能范围内的变化所产生的影响仍不清楚。本研究的主要目的是确定当肾功能保持在生理水平时，是否有必要针对肾功能的特定水平进行调整。我们研究了在法兰克福大学医院接受腰椎穿刺的183例患者（神经退行性疾病患者122例；其他神经系统疾病患者39例；躯体形式障碍对照组患者22例）。使用单分子阵列（SIMOA）技术测量神经丝轻链（NfL）、胶质纤维酸性蛋白（GFAP）、总tau蛋白（tTAU）和泛素C末端水解酶L1（UCHL1）的血清和脑脊液（CSF）水平。估算肾小球滤过率（eGFR）与脑脊液GFAP呈负相关（r = -0.217，P = 0.004），与血清NfL呈负相关（r = -0.164，P = 0.032）。肾功能受损的患者脑脊液NfL（P = 0.036）和脑脊液GFAP（P = 0.026）水平较高。然而，在调整体重指数（BMI）和年龄后，这些发现不再具有统计学意义。重要的是，在肾功能正常的患者中，调整后未观察到eGFR与生物标志物水平之间存在显著相关性。我们的研究结果表明，NfL、GFAP、tTAU和UCHL1的血清和脑脊液浓度不受生理性肾功能波动的显著影响，但强调在解释生物标志物水平时考虑肾功能受损合并症的重要性。
