Background. This study aims to establish age- and gender-specific cystatin C (CysC) reference values for healthy infants, children, and adolescents and to relate them to pubertal stage, height, weight, and body mass index (BMI).
Methods. Serum CysC and creatinine levels of 6217 fasting, morning venous blood samples from 2803 healthy participants of the LIFE Child study (age 3 months to 18 years) were analyzed by an immunoassay. Recruitment started in 2011; 1636 participants provided at least one follow-up measurement. Percentiles for CysC were calculated. Age- and gender-related effects of height, weight, BMI, and puberty status were assessed through linear regression models.
Results. Over the first 2 years of life, median CysC levels decrease depending on height (ß = − 0.010 mg/l/cm, p < 0.001) and weight (ß = − 0.033 mg/l/kg, p < 0.001) from 1.06 to 0.88 mg/l for males and from 1.04 to 0.87 mg/l for females. Following the second year of age, the levels remain stable for eight years. From 11 to 14 years of age, there is an increase of median CysC levels in males to 0.98 mg/l and a decrease in females to 0.86 mg/l. The change is associated with puberty (ß = 0.105 mg/l/Tanner stage, p < 0.001 in males and ß = − 0.093 mg/l/Tanner stage, p < 0.01 in females) and in males with height (ß = 0.003 mg/l/cm, p < 0.001).
Conclusions. CysC levels depend on age, gender, and height, especially during infancy and puberty. We recommend the use of age- and gender-specific reference values for CysC serum levels for estimating kidney function in clinical practice.:1 Contents ........................................................................................................... 1
2 Introduction ...................................................................................................... 2
GFR measurement ............................................................................................. 2
Technically advanced methods ........................................................................ 2
Serum creatinine................................................................................................ 3
Serum Cystatin C............................................................................................... 3
Current state of research..................................................................................... 5
Reference values of Cystatin C ......................................................................... 5
Cystatin C in healthy test persons .................................................................... 6
Validity of Cystatin C for kidney diseases.......................................................... 6
Post-transplant validity of Cystatin C ............................................................... 7
Validity of Cystatin C in extra-renal diseases .................................................... 7
GFR-equations................................................................................................... 8
Confounders ...................................................................................................... 9
Relevance of the topic ......................................................................................... 11
Hypothesis ........................................................................................................... 13
3 Publication – manuscript................................................................................... 14
4 Summary and interpretation ............................................................................. 16
5 References ........................................................................................................ 20
6 Appendix ........................................................................................................... I
7 Description of the own contributions ................................................................ VII
8 Erklärung über die eigenständige Abfassung der Arbeit .................................. VIII
9 Curriculum vitae ................................................................................................ IX
10 Scientific publications and presentations ....................................................... XI
11 Acknowledgements.......................................................................................... XII
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:36268 |
| Date | 25 November 2019 |
| Creators | Ziegelasch, Niels |
| Contributors | Universität Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:doctoralThesis, info:eu-repo/semantics/doctoralThesis, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | https://doi.org/10.1007/s00467-018-4087-z |
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