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Query: UNIPROT:P01034 (
cystatin C
)
3,397
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Cystatin C is a small basic protein with a MW of 13,359 Daltons, consisting of a non-glycosylated polypeptide chain containing 120 amino-acid residues. Cystatin C is produced in all the nucleated cells of the human body and its output rate is constant. The kidney is the main catabolic site of
cystatin C
, since the protein, by virtue of its low MW and its positive charge at normal pH, is freely filtered by the glomerulus and almost completely reabsorbed, catabolised and broken down in the cells of the proximal convoluted tubule. It is practically entirely filtered via the glomerular membrane, without any significant tubular secretion. The constant production rate of
cystatin C
in all the tissues, its elimination via the glomerular filter and its non-dependence on many extrinsic factors, including sex, age, diet, inflammation, are potentially ideal conditions for an endogenous biochemical marker of glomerular filtration. A recent method for determining
cystatin C
, is based on an immune reaction, could increase its clinical application. Not many studies have been conducted to date on
cystatin C
in children. The
cystatin C
concentration was higher during the first few days of life (range: 1.64-2.59 mg/L) with a rapid reduction during the first 4 months. Beyond the first year of life,
cystatin C
concentration became constant, with a reference range of 0.7-1.38 mg/L. On the basis of the data currently available, neonatal serum
cystatin C
would appear to derive from the newborn itself. In fact no correlations were found between maternal and neonatal serum
cystatin C
values. Cystatin C determination appears to be at least equivalent to serum
creatinine
measurement for the assessment of glomerular filtration rate in children. Further extended studies are needed to investigate these aspects more thoroughly in neonates.
...
PMID:Cystatin C in paediatric nephrology. Present situation and prospects. 1047 83
Human
cystatin C
, a basic low molecular mass protein with 120 amino acid residues, is freely filtered by the glomerulus and almost completely reabsorbed and catabolized by the proximal tubular cells. Cystatin C has been recently proposed as a new sensitive endogenous serum marker for the early assessment of changes in the glomerular filtration rate. To define a reference basis for future clinical investigations in the perinatal period, we investigated the relationship between maternal and neonatal serum
cystatin C
in comparison with that of
creatinine
. We also defined reference values in healthy women at full-term pregnancy and in full-term newborns over the first 5 days of life. Seventy-eight women with uncomplicated pregnancy, aged between 19 and 40 years, and their infant newborns (43 males, 35 females) were enrolled in the study. The gestational age ranged from 37 to 43 weeks, and the birth weight from 2.50 to 4.15 kg. Blood samples were taken from all the women immediately before delivery and from their newborns at birth, 72 and 96 h after birth. Maternal and neonatal renal function was evaluated by standards parameters and by calculating
creatinine
clearance. In all serum samples, we measured
cystatin C
,
creatinine
, and urea. At term gestation, serum
cystatin C
ranged from 0.64 to 2.30 mg/L. At birth, serum
cystatin C
values ranged from 1.17 to 3.06 mg/L, significantly decreasing after 3 and 5 days of life. No correlation was found between maternal and neonatal serum
cystatin C
values (r = 0.09). As
cystatin C
serum levels in newborns are not significantly correlated with the respective maternal levels, neonatal serum
cystatin C
may originate almost exclusively in the neonate.
...
PMID:Cystatin C in healthy women at term pregnancy and in their infant newborns: relationship between maternal and neonatal serum levels and reference values. 1058 82
We determined plasma concentrations of
cystatin C
, beta2-microglobulin - beta2-MG (low molecular mass protein markers of glomerular filtration rate - GFR),
creatinine
(marker of GFR) and urinary N-acetyl-beta-D-glucosaminidase (NAG) excretion (marker of glomerular and tubular dysfunction) in 41 non-insulin-dependent diabetic patients. A significant increase of all the measured parameters (p<0.001, p<0.05, p<0.05 and p<0.001, respectively) in comparison to the control group, was observed. In the patients with microalbuminuria, only plasma
cystatin C
concentration and urinary NAG excretion increased significantly in comparison to patients with normoalbuminuria. At a cut-off level of 1.74 mg/l for
cystatin C
and 1.81 U/g
creatinine
for NAG (95% percentile of the normoalbuminuric group), the sensitivity of the tests for detecting microalbuminuria was 82% for
cystatin C
and 86% for NAG. The specificities were 88 and 92%, respectively. The present study demonstrated that determination of plasma
cystatin C
might be useful in the detection of incipient diabetic nephropathy and is a potentially better marker than
creatinine
or beta2-MG. No correlation between parameters measured in plasma or urine and glycated hemoglobin was found.
...
PMID:Plasma cystatin C concentration in non-insulin-dependent diabetes mellitus: relation with nephropathy. 1060 39
Serum
cystatin C
measurement has been previously shown by ourselves and others to be a better indicator of changes in glomerular filtration rate (GFR) than serum
creatinine
. However, the available literature on reference values for
cystatin C
concentration remains surprisingly sparse; we thus set out to determine an adult reference range. Blood was taken from 309 healthy blood donors and
creatinine
and
cystatin C
concentrations were measured using commercially available automated methodologies. In addition, predicted
creatinine
clearances were calculated using the Cockcroft and Gault formula. The 95% reference intervals for
creatinine
, predicted
creatinine
clearance and
cystatin C
for all blood donors, regardless of gender, were 68-118 mumol/L, 58-120 ml/min/1.73 m2 and 0.51-0.98 mg/L, respectively. For women, the intervals were 68-98 mumol/L, 60-119 ml/min/1.73 m2 and 0.49-0.94 mg/L; for men, they were 78-123 mumol/L, 57-122 ml/min/1.73 m2 and 0.56-0.98 mg/L. This mean 95% reference interval for
cystatin C
in all donors under 50 years of age was 0.53-0.92 mg/L; for those over 50 years of age it was 0.58-1.02 mg/L. The small difference between make and female ranges meant that a single reference range for
cystatin C
could be established for all adults under 50 years of age without adjustment for body surface area. Serum
cystatin C
measurement offers a simpler and more sensitive screening test than serum
creatinine
for early changes in GFR.
...
PMID:Adult reference ranges for serum cystatin C, creatinine and predicted creatinine clearance. 1067 73
In an effort to increase our knowledge of the optimal use of serum
cystatin C
and
creatinine
as glomerular filtration rate (GFR) markers, these variables, as well as lean tissue mass and GFR, were determined in a population of 42 healthy young adults (men and women with normal GFR). Dual-energy X-ray absorptiometry and measurement of the plasma clearance of iohexol were used to measure lean tissue mass and GFR, respectively. Serum
creatinine
was significantly correlated to lean tissue mass (r=0.65; p < 0.0001) but not to GFR (1/
creatinine
vs. GFR: r=0.11; p=0.106). In contrast, serum
cystatin C
correlated with GFR (1/
cystatin C
vs. GFR: r=0.32; p=0.0387), especially in men (1/
cystatin C
vs. GFR: r=0.64; p=0.0055), but not to lean tissue mass. These results might explain previous observations that serum
cystatin C
seems to be a better marker for GFR than serum
creatinine
, particularly for individuals with small to moderate decreases in GFR. However, the results also show that the serum concentrations of both
creatinine
and
cystatin C
are determined not only by GFR, but also by other factors. Since these additional factors differ for
cystatin C
and
creatinine
, it seems justified to use serum
creatinine
and
cystatin C
in conjunction to estimate GFR, at least until it is known in what situations serum
creatinine
or
cystatin C
is the preferable marker.
...
PMID:Relationships among serum cystatin C, serum creatinine, lean tissue mass and glomerular filtration rate in healthy adults. 1069 Oct 49
Serum
cystatin C
, a cysteine proteinase inhibitor, has been proposed as a marker of glomerular filtration rate (GFR). Serum
cystatin C
, serum
creatinine
and
creatinine
clearance were measured in 226 patients with various nephropathies, covering the entire range of renal function, to evaluate the efficacy of
cystatin C
as a screening test to detect reduced
creatinine
clearance in comparison to
creatinine
. Subgroups of 53 patients with glomerular and 26 patients with tubular impairment were compared to assess whether
cystatin C
performed differently in either glomerular or tubular impairment. Cystatin C detected reduced
creatinine
clearance with higher sensitivity (97 vs. 83%), and higher negative predictive value (96 vs. 87%) compared to
creatinine
. In parallel, 95% sensitivity of
cystatin C
as derived from receiver-operating characteristic plot was significantly higher (p < 0.05). In the subgroups with glomerular or tubular impairment,
cystatin C
and
creatinine
did not significantly differ with regard to efficacy. Serum
cystatin C
is as efficacious as serum
creatinine
to detect reduced GFR as measured by
creatinine
clearance. The efficacy of
cystatin C
as a screening test may even be superior compared to
creatinine
. In addition, the efficacy of
cystatin C
is independent of either glomerular or tubular impairment.
...
PMID:Cystatin C: efficacy as screening test for reduced glomerular filtration rate. 1077 8
The assessment of the glomerular filtration rate (GFR) is the most commonly used test of renal function. The accepted reference procedure employs an exogenous clearance marker whilst the most popular test is that of serum or plasma
creatinine
. All of these tests have limitations, although the surrogate endogenous markers are the most practical. Cystatin C, a low molecular weight protein which can be measured by light scattering immunoassay, possesses many of the attributes required of the ideal GFR marker. Data on reference ranges indicate that circulating
cystatin C
levels reflect the variation in GFR throughout life and the marker demonstrates a better correlation with the reference procedure than serum
creatinine
.
...
PMID:Developments in the assessment of glomerular filtration rate. 1084 8
It has been reported that
cystatin C
(cys-C) is elevated in patients with malignant disease. In order to investigate whether this phenomenon is linked to or independent of renal function, and at the same time examine the role of this marker in other pathological situations, cys-C concentrations were compared with 24-h
creatinine
clearance values in three groups of patients; the first group were undergoing treatment for malignant disease, the second group were renal transplant patients and the third randomly taken from patients for whom a routine
creatinine
clearance had been requested. Several patients with malignant disease had high cys-C levels without any correspondence to
creatinine
clearance values. Additionally, although cys-C shows a high sensitivity for detecting impaired glomerular function in renal transplant patients, the specificity was very low, with little discrimination being observed between patients with normal and pathological
creatinine
clearance levels. In other patients both the sensitivity and specificity of cys-C could be shown to be very good. Thus although cys-C can generally be recommended as a marker of the glomerular filtration rate, there are some patients for whom the clinical relevance is unclear.
...
PMID:Clinical value of cystatin C determination. 1084 9
Cystatin C is a nonglycosylated basic protein produced at a constant rate by all investigated nucleated cells. It is freely filtered by the renal glomeruli and primarily catabolized in the tubuli (not secreted or reabsorbed as an intact molecule). Because serum
cystatin C
concentration is independent of age, sex, and muscle mass, it has been postulated to be an improved marker of glomerular filtration rate (GFR) compared with serum
creatinine
level. We compared serum
cystatin C
level with other markers of GFR, such as serum
creatinine
level and
creatinine
clearance, and analyzed their variations based on iothalamate labeled with iodine 125 ((125)I-iothalamate) clearance ((125)I-ICl), used as the gold standard for GFR. The concentrations of the two different markers of GFR in patients with impaired renal function were classified according to (125)I-ICl. Twenty individuals with normal renal function ((125)I-ICl, 128 +/- 23 mL/min/1.73 m(2)) were used as the control group. Serum
cystatin C
level showed a greater sensitivity (93.4%) than serum
creatinine
level (86.8%). Also, serum
cystatin C
showed the greatest proportion of increased values in patients with impaired renal function (100%) compared with serum
creatinine
level (92.15%). Serum
cystatin C
levels started to increase to greater than normal values when GFR was 88 mL/min/1.73 m(2), whereas serum
creatinine
level began to increase when GFR was 75 mL/min/1.73 m(2). These data suggest that measurement of serum
cystatin C
may be useful to estimate GFR, especially to detect mild reductions in GFR, and therefore may be important in the detection of early renal insufficiency in a variety of renal diseases for which early treatment is critical.
...
PMID:Serum cystatin C as a new marker for noninvasive estimation of glomerular filtration rate and as a marker for early renal impairment. 1115 92
The effect of asthma pathogenesis on serum
cystatin C
, a potent inhibitor of cysteine proteinases and a newly proposed marker of the renal function, has not been yet determined. The objectives were to determine the 24-h pattern of
cystatin C
and
creatinine
concentrations in sera of asthmatic patients in order to test whether their concentrations might reflect circadian rhythms, the disease severity and the effect of therapy. Serum concentrations of
cystatin C
and
creatinine
were determined in steroid-independent and steroid-dependent asthmatics before and after 1 week of treatment with methylprednisolone and cyclosporin A, respectively. Samples were collected every 4 h during a 24-h period. Little or no significant effects of time on
cystatin C
and
creatinine
concentrations over a 24-h period were observed in healthy and asthmatic sera. However, significantly higher
cystatin C
concentrations were found in asthmatic patients compared to controls which suggests its role in the pathogenesis of asthma. Methylprednisolone increased and cyclosporin A decreased serum
cystatin C
concentrations after 1 week of therapy. Additionally these results support the need for the evaluation of
cystatin C
as a marker of glomerular filtration rate determination in asthma.
...
PMID:Serum cystatin C, a potent inhibitor of cysteine proteinases, is elevated in asthmatic patients. 1095 65
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