Thyroid function differently affects serum cystatin C and creatinine concentrations
Thyroid function differently affects serum cystatin C and creatinine concentrations
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DOI：
10.1007/bf03347201
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发表时间：
2005-04-01
影响因子：
5.4
通讯作者：
Martino, E
中科院分区：
文献类型：
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作者：
Manetti, L;Pardini, E;Martino, E
胱抑素 C (Cys C) 是一种半胱氨酸蛋白酶抑制剂，由有核细胞以恒定速率产生，通过肾小球膜过滤并被肾小管细胞重吸收。这项横断面和纵向研究的目的是评估甲状腺功能障碍患者的血清 Cys C 和肌酐 (Crea) 浓度。 181 例患者入组，其中 26 例未经治疗的非毒性结节性甲状腺肿患者、58 例甲状腺功能亢进症患者、31 例接受 L-T-4 抑制治疗的非毒性结节性甲状腺肿患者、35 例停药 L-T-4 后进行甲状腺癌全身扫描后短期甲状腺功能减退症患者、11 例因慢性自身免疫性甲状腺炎导致的长期甲状腺功能减退症患者和 20 例轻度甲状腺功能减退症患者。研究。五十七名年龄和性别匹配的正常受试者作为对照。评估血清 Cys C、Crea、游离 T-4 (FT4)、FT3 和 TSH。对 30 名甲状腺功能亢进患者和 35 名短期甲状腺功能减退患者进行前瞻性随访，直至通过甲巯咪唑或 L-T-4 治疗达到甲状腺功能正常。横断面研究表明，明显甲状腺功能亢进或亚临床甲状腺功能亢进患者的平均血清 Crea 浓度显着降低，而明显甲状腺功能减退患者的平均血清 Crea 浓度则升高，但轻度甲状腺功能减退症患者的平均血清 Crea 浓度却没有增加。相反，与对照组相比，明显甲状腺功能亢进患者的血清Cys C水平显着升高（p < 0.05），而短期、长期和轻度甲状腺功能减退患者的血清Cys C水平显着降低（分别为p < 0.05、p < 0.05、p < 0.01）。然而，36 名（62%）甲状腺功能亢进患者和 50 名（76%）甲状腺功能减退患者的血清 Cys C 值正常。在前瞻性研究中，通过甲硫咪唑或 L-T4 治疗恢复甲状腺功能正常与平均血清 Cys C 浓度正常化相关。总之，甲状腺功能障碍会影响血清Cys C浓度，可能影响蛋白质的产生率。然而，甲状腺功能亢进或甲状腺功能减退患者的血清 Cys C 水平正常的观察结果限制了其作为外周甲状腺激素效应标志物的用途。 (c) 2005 年，Editrice Kurtis。
Cystatin C (Cys C) is a cysteine protease inhibitor produced at a constant rate by nucleated cells, filtered through the glomerular membrane and reabsorbed by kidney tubular cells. Aim of this cross-sectional and longitudinal study was to assess serum Cys C and creatinine (Crea) concentrations in thyroid dysfunction. One hundred and eighty-one patients, 26 with untreated non-toxic nodular goiter, 58 with hyperthyroidism, 31 on L-T-4 suppressive therapy for non-toxic nodular goiter, 35 with short-term hypothyroidism after L-T-4 withdrawal to perform whole body scan for thyroid cancer, 11 with long-term hypothyroidism due to chronic autoimmune thyroiditis and 20 patients with mild hypothyroidism were enrolled in the study. Fifty-seven age- and sex-matched normal subjects served as controls. Serum Cys C, Crea, free T-4 (FT4), FT3 and TSH were assessed. Thirty hyperthyroid patients and 35 short-term hypothyroid patients were followed prospectively until euthyroidism was reached by methimazole or L-T-4 therapy. The cross-sectional study showed that mean serum Crea concentrations were significantly reduced in overt hyperthyroid or subclinical hyperthyroid patients, while it was increased in overt hypothyroid patients, but not in mild hypothyroidism. Conversely, serum Cys C levels were significantly increased in overt hyperthyroid patients compared to controls (p < 0.05), and significantly decreased in short-term, long-term and mild hypothyroids (p < 0.05, p < 0.05, p < 0.01, respectively). However, 36 (62%) hyperthyroid patients and 50 (76%) hypothyroid patients had normal serum Cys C values. In the prospective study, restoration of euthyroidism by either methimazole or L-T4 therapy was associated with normalization of mean serum Cys C concentrations. In conclusion, thyroid dysfunction affects serum Cys C concentration, possibly influencing the production rate of the protein. However, the observation that hyper- or hypothyroid patients have normal serum Cys C levels limits its use as a marker of peripheral thyroid hormone effect. (c) 2005, Editrice Kurtis.