THE SIGNIFICANCE OF CYSTATINE С IN PRE-CLINICAL DIAGNOSING OF PRE-ECLAMPSIA IN PREGNANT WOMEN
DOI:
https://doi.org/10.11603/24116-4944.2019.2.10933Keywords:
pre-eclampsia, cystatin C, glomerular filtration rate for cystatin C, creatinine, predictorAbstract
The aim of the study – evaluation of serum cystatine С (sСc) level and establishment of its efficacy for pre-eclampsy (PE) diagnosing at the pre-clinical stage compared to traditional prediction method based on serum creatinine level evaluation.
Materials and Methods. 30 pregnant patients at first trimester of pregnancy were enrolled. 20 patients with a history of PE risk factors were included into study group (SG), 10 females without any extra-genital disease or obstetrics and gynecology history were included into control group (CG). SG was subdivided into subgroups based on sCc levels and were evaluated at gestation weeks 22–36. Subgroup Ic>1 included females with sCc level over 1.0 (n=10), females with sCc level less than 1.0 were enrolled into subgroup Ic<1 (n=10). Pregnant females with PE reported at the end of gestation were included into group Ia (n=8). Group Ib included patients without PE (n=12).
Results and Discussion. SCc levels (1.34±0.11) (95% CI 1.13–1.55) (p<0.001) were reported in subgroup Ia. SCc sensitivity for PE prediction in Ic>1 group was 87.5%, with specificity level 100%. These results were supported by high diagnostic value of sCc level for PE prediction. In Ic<1 subgroup sCc level was (0.88±0.03) (95 % CI 0.81 -0.95) (p<0.001); pre-eclampsy has not been reported in this subgroup. Comparative analysis of glomerular filtration rate (GFR) for sCc (GFRcys) and GFR for creatinine (GFRcr) demonstrated statistically significant difference in group Ia: GFRcys value was (58.62±4.11) (95 % CI 50.57–66.68) that was significantly lower compared to GFRcr – (88.25±5.76) (95% CI 79.96–99.54); in control group the statistical difference of GFRcys (114.5±2.7) (95% CI 109.2–119.8)) and GFRcr (112.5±4.1) (95 % CI 104.47–120.53)) was not reported. Therefore, the most significant difference of GFRcys and GFRcr values was reported in group Ia. It confirms the efficacy of GFRcys parameter implementation for diagnosing of renal dysfunction at preclinical PE stage.
Conclusion. The study demonstrates that serum cistatine C level is significantly elevated in pregnant females that belong to a PE risk group. Values over 1.0 are considered a reliable marker of pre-eclampsy at the pre-clinical PE stage.
References
Poon, L.C., Shennan, A., Hyett, J.A., Kapur, A., Hadar, E., Divakar, H., …, & Hod, M. (2019). The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int. J. Gynecol. Obstet., 145, S1, 1-33. DOI: https://doi.org/10.1002/ijgo.12802
Davidenko, K. (2019). Plenum Asoctsiatsii akusheriv-hinekolohiv Ukrainy: aktualni ta dyskusiini pytannia [Plenum of the Association of Obstetricians-Gynecologists of Ukraine: Сurrent and Discussion Questions]. Ukrainskyi medychnyi chasopys – Ukrainian Medical Journal, 5 (1), 133. Retrieved from: https: //www.umj.com.ua/article/163339/ [in Ukrainian].
O'Gorman, N., Wright, D., Poon, L.C., Rolnik, D.L., Syngelaki, A., Wright, A., …, & Nicolaides, K.H. (2017). Accuracy of competing- risks model in screening for pre-eclampsia bymaternal factors and biomarkers at 11-13 weeks’gestation. Ultrasound Obstet. Gynecol., 49, 751-755. DOI: https://doi.org/10.1002/uog.17399
Christian Thomas, & Lothar Thomas. (2009). Renal failure-measuring the glomerular filtration rate. Dtsch. Arztebl. Int., 106 (51-52), 849-854.
Velkov, V.V. (2015). Tsistatin C i NGAL – markery preklinicheskoy renalnoy disfunktsii i subklinicheskogo ostrogo povrezhdeniya pochek [Cystatin C and NGAL – the Markers of Preclinical Renal Dysfuction and Subclinical Acute Kidney Injury]. Laboratornaya sluzhba – Laboratory Service, 2, 38-43 [in Russian].
Niraula, A., Lamsal, M., Baral, N., Majhi, S., Ahmed Khan, S., Basnet, P., & Dahal, K. (2017). Cystatin-C as a Marker for Renal Impairment in Preeclampsia. J. of Biomarkers, Article ID 7406959. DOI: 10.1155/2017/7406959. DOI: https://doi.org/10.1155/2017/7406959
Hoek, F.J., Kemperman, F.A., & Krediet, R.T. (2003). A comparison between cystatin C, plasma creatinine and the Cockroft and Gault formula for the estimation of glomerular filtration rate. Nephrol. Dial. Transplant.,18, 2024-2031. DOI: https://doi.org/10.1093/ndt/gfg349
Levey, A.S., Stevens, L.A., Schmid, C.H., Zhang, Y.L., Castro, A.F. 3rd, Feldman, H.I., …, & Coresh, J. (2009). A new equation to estimate glomerular filtration rate. Ann. Intern. Med., 150 (9), 604-612. DOI: https://doi.org/10.7326/0003-4819-150-9-200905050-00006
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