Serum Cys Research Articles

Establishment of reference intervals of homocysteine, cysteine, and methionine in apparently healthy Chinese adults

Background It has been widely reported that the key biomarkers of homocysteine metabolic pathways have emerged as markers or independent risk factors for cardiovascular disease and many other diseases. To improve the accuracy of evaluation in China, we establish the reference intervals of serum homocysteine (Hcy), cysteine (Cys), and methionine (Met) in apparently healthy Chinese adults. Methods We examined 1553 subjects aged ≥20 years who underwent Hcy metabolic pathway tests, in the Chaoyang Central Hospital between January 2019 and December 2020. The serum Hcy, Cys, and Met levels were simultaneously determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Multiple regression analysis was performed to identify sources of variation. A nonparametric method was used to establish the reference intervals. Results Gender differences were observed in Hcy and Met, with higher levels in males. Reference intervals for males were 6.09–17.00 μmol/L (Hcy) and 19.31–33.68 μmol/L (Met); conversely, the reference intervals for females were 4.61–14.61 μmol/L (Hcy) and 16.16–30.35 μmol/L (Met). The serum Cys reference intervals were seen to be gender-independent, but age-dependent reference intervals were needed; those for Cys were 188.85–334.27 μmol/L, 200.48–340.66 μmol/L, and 216.03–349.67 μmol/L in <40, 40–50, and ≥50 years, respectively. Conclusions By this study, the gender- or age-specific reference intervals of Hcy, Cys, and Met that were matched with the Chinese population were established, providing valuable references for clinical work and laboratory researches.

Elevated Serum Cystatin C and Decreased Cathepsin S/Cystatin C Ratio Are Associated with Severe Peripheral Arterial Disease and Polyvascular Involvement.

Peripheral arterial disease (PAD) is frequently associated with atherosclerotic manifestations of the carotids and coronaries. Polyvascular involvement and low ankle–brachial index predict major cardiovascular events and high mortality. Cathepsin S (Cat S) promotes the inflammatory pathways of the arterial wall, while Cystatin C (Cys C) functions as its inhibitor; therefore, Cys C was proposed to be a biomarker of progression in PAD. In a single-center observational study, we investigated the correlations of serum Cys C and Cat S/Cys C ratio in a group of 90 PAD patients, predominantly with polyvascular involvement. Cys C and Cat S/Cys C were associated with ankle–brachial index (ABI) scores <0.4 in univariate and multiple regression models. Furthermore, both markers correlated positively with the plasma Von Willebrand Factor Antigen (VWF: Ag) and Von Willebrand Factor collagen-binding activity (VWF: CB). In addition, Cat S/Cys C was significantly decreased, whereas Cys C increased in subjects with three-bed atherosclerotic involvement. According to our results, high serum Cys C and low Cat S/Cys C ratios may indicate severe peripheral arterial disease and polyvascular atherosclerotic involvement.

The value of cystatin C in predicting perioperative and long-term prognosis of renal transplantation

This study aimed to evaluate the value of cystatin C (Cys C) in predicting the perioperative and long-term prognosis of renal transplantation (RT). The clinical data of 198 RT recipients were collected. Blood samples were obtained daily until 7 d after transplantation and then discharge day to determine the serum levels of Cys C. The receiver-operating characteristic (ROC) analysis and the area under the curve (AUC) were used to determine the diagnostic accuracy of Cys C for delayed graft function (DGF). The presence of shrunken pore syndrome (SPS) with a cystatin C-based estimate of glomerular filtration rate less than 70% of a creatinine-based estimate, was also evaluated as a prognostic factor for the development of DGF. The serum Cys C levels of patients with DGF were higher than those of the non-DGF group. Cys C showed a higher AUC (0.928) in the ROC analysis than did sCr (0.862). Compared to the non-SPS group, there were more patients diagnosed with SPS in the DGF group (p < .05). The follow-up data showed that patients diagnosed with SPS had higher levels of sCr and Cys C compared to other patients, suggesting a poor long-term prognosis. Our findings suggest that Cys C is a sensitive indicator of renal function during the perioperative period. Cys C at a concentration of 4.9 mg/L had the highest sum of sensitivity and specificity for prediction of DGF, with a sensitivity of 0.889 and a specificity of 0.8. SPS is associated with the development of DGF and the poor long-term prognosis of RT.

Reference Interval of Serum Cystatin C in Dravidian Population Subset of South Asian Ethnic Groups: An Observational Cross-sectional Study

Introduction: Serum Cystatin C (Cys C) facilitates to detect mild renal dysfunction and overall risk of death in older patients with chronic renal diseases. The requirement for creating a particular reference interval is mandatory for such renal diseases in South Asian population since the value of serum creatinine varies largely with age, gender and population/ethnicity and data of same is short for South Asian population. Aim: To determine the reference interval of serum Cystatin C amongst the Dravidian population subset of South Asian ethnic groups. Materials and Methods: This observational cross-sectional study was conducted in Department of Biochemistry and Transfusion Medicine at Government Medical College, Thrissur, Kerala, India, from July 2020 to January 2021 among on 235 healthy adults (20-60 years). A 4 mL of blood was drawn by aseptic precautions and serum was separated within three hours of blood collection. Serum Cys C was assayed by latex enhanced immunoturbidimetric cystatin C assay using a calibrator traceable to international standard European Specific Protein Reference Material (ERM DA-471) developed by the International Federation of Clinical Chemistry (IFCC) and Laboratory Medicine. Serum creatinine (sCr) by Jaffe method in a fully automatic clinical chemistry analyser. Categorical variables are presented using frequency (percentage) while continuous variables are summarized with an inter-percentile range. The Kolmogorov-Smirnov test was used to assess the normality of the distribution of continuous variables. Results: Total of 235 subjects (20-60 years of age, 17 males and 218 females) were included in the study. The non parametric reference intervals for Cys C were found to be from 0.39 to 0.79 mg% and that of sCr ranged from 0.79 to 1.2 mg%. The relationship between Cystatin C with age showed an increase in Cystatin C levels as age advances; Spearman's rank correlation coefficient (rho=0.197). The weak correlation between Cystatin C and sCr was also observed (rho=0.37; p-value &lt;0.0001). Conclusion: The level of serum cystatin C (0.39 to 0.79 mg%) can be used as a diagnostic concentration reference interval of the protein that helps to recognise, standardise and establish it as a potential biomarker to detect renal disorders in South Asian ethnic population.

Relationship between serum IL-6, VAP-1, Cys C, Scr, BUN, and type 2 diabetic kidney disease.

Relationship between serum IL-6, VAP-1, Cys C, Scr, BUN, and type 2 diabetic kidney disease.

Associations of serum cystatin C with depressive symptoms and suicidal ideation in major depressive disorder

BackgroundIndividuals with major depressive disorder (MDD) have high suicidal ideation. There is evidence that serum cystatin C (Cys C) may be involved in the pathophysiology of MDD. The present study aimed to investigate Cys C concentration in patients with MDD and clarify its possible association with depressive symptoms and suicidal ideation.MethodsAn online cross-sectional survey of 159 patients diagnosed with MDD was conducted. Serum Cys C levels were measured using ADVIA 2400 biochemical analyzer. The 24-item Hamilton Depression Scale (HAMD-24) was administered to evaluate the depressive symptoms. Generalized linear regression, logistic regression and restricted cubic spline models were used to examine the association of serum Cys C levels with depressive symptoms and suicidal ideation.ResultsSerum Cys C levels were higher in MDD patients than in controls (p = 0.001) and were positively associated with scores on HAMD-24 in unadjusted (gender distribution, age, smoking, alcohol consumption, family history of depression and traumatic life events; (p = 0.003) and fully adjusted linear regression model (p = 0.005). The fully adjusted regression coefficient with 95% confidence intervals for serum Cys C levels and HAMD-24 score was 30.339 (9.602 to 51.077). The level of Cys C in the suicidal ideation (SI) group was significantly higher than that in the non-suicide ideation (non-SI) group (p = 0.001). Serum Cys C levels were positively associated with suicidal ideation in each logistic regression model (all p < 0.05).ConclusionSerum Cys C levels were elevated in MDD patients and appeared to be positively correlated with depressive symptoms and suicidal ideation. These findings suggest that the dysfunction of Cys C may be involved in the severity of depression and in the pathophysiological process of MDD. Thus, regulation of serum Cys C could potentially be an effective predictor of the severity of depression and potentially, play a role in reducing the risk of suicide in MDD patients.

Correlation and Diagnostic Value of Serum Cys-C, RBP4, and NGAL with the Condition of Patients with Traumatic Acute Kidney Injury.

There is a lack of targeted biomarkers that can diagnose Acute Kidney Injury (AKI) early and accurately, which leads to deterioration of renal function and even death in patients who do not receive timely and effective treatment. In recent years, an increasing number of studies have shown that AKI-related markers such as cystatin C (Cys-C) and retinol-binding protein (RBP) can be used for early diagnosis of AKI to a certain extent. A total of 262 subjects were included in this study, of which 132 patients with traumatic AKI were enrolled in one group and named as the AKI group; 130 healthy subjects were enrolled in another group and named as the healthy group. AKI patients with different conditions were classified into AKI phase I, II, and III according to the KDIGO AKI diagnostic criteria, with 45, 59, and 28 in each group. In this study, we examined and compared serum Cys-C, RBP4, and neutrophil gelatinase-associated lipid transport protein (NGAL) levels between the AKI and healthy groups and between patients with AKI of different conditions, and the correlation and diagnostic value of three serum markers with the condition of traumatic AKI patients were also analyzed. The results showed that serum Cys-C, RBP4, and NGAL were significantly higher in the AKI group compared with the healthy group (P < 0.05), and the mean concentrations of the three serum markers increased as the severity of the disease increased, while correlation analysis showed that all three serum markers were positively correlated with serum Scr levels (P < 0.001). Further ROC curve analysis was performed, and the diagnostic values of serum Cys C, RBP4, and NGAL alone and in combination for traumatic AKI were 0.769, 0.741, 0.771, and 0.905, respectively. In short, serum Cys C, RBP4, NGAL have important value for the assessment and diagnosis of traumatic AKI patients.

Correlation of Serum Cystatin C with Renal Function in Gout Patients with Renal Injury.

The gout-induced continuous deposition of urate in the kidney tissues is the main cause of renal injury, for which cystatin C (Cys C) is an important indicator. This research analyzed the correlation between general renal injury indicators and serum Cys C level, and further investigated the potential of Cys C in renal injury diagnosis. A total of 140 gout patients with renal injury (GRI) were recruited and grouped by their glomerular filtration rate (GFR). Urea nitrogen, uric acid, creatinine, and Cys C levels in the serum were evaluated. The diagnostic efficacy of serum Cys C was evaluated by the nonparametric receiver operating characteristic analysis. Serum Cys C level was increased with decreased GFR in GRI. Urea nitrogen, uric acid, and creatinine levels in the serum showed positive correlations with Cys C level. The area under the curve for serum Cys C was 0.8589 (P < 0.001). In conclusion, this research demonstrated that the serum Cys C level was a precise diagnostic marker for GFR and renal damage evaluation, and showed a significant diagnostic value for renal injury in patients with gout.

Cystatin C predicts the risk of incident cerebrovascular disease in the elderly: A meta-analysis on survival date studies.

Background:Stroke is the third leading cause of global year of life lost in all-age and second-ranked cause of disability adjusted life years in middle-aged and elder population. Therefore, it is critical to study the relationship between vascular-related risk factors and cerebrovascular diseases. Several cross-sectional studies have shown that Cystatin C (Cys C) is an independent risk factor for cerebrovascular diseases and levels of Cys C are significantly higher in stroke patients than in healthy individuals. In this meta-analysis, we introduce a Cox proportional hazards model to evaluate the causality between Cys C and the risk of cerebrovascular accident in the elderly.Methods:We searched PubMed, EMBASE, the Web of Science, and the Cochrane Library from 1985 to 2019 for studies on the relationship between serum Cys C and incidence stroke with Cox proportional hazards models. We conducted a subgroup analysis of the selected studies to determine a connection between atherosclerosis and stroke. Finally, 7 research studies, including 26,768 patients without a history of cerebrovascular, were studied.Results:After comparing the maximum and minimum Cys C levels, the hazard ratio for all types of stroke, including ischemic and hemorrhagic stroke, was 1.18 (95% confidence interval 1.04–1.31) with moderate heterogeneity (I2 = 43.0%; P = .119) in a fixed-effect model after pooled adjustment for other potential risk factors. In the subgroup analysis, the hazard ratio and 95% confidence interval for Cys C stratified by atherosclerosis was 1.85 (0.97–2.72). As shown in Egger linear regression test, there was no distinct publication bias (P = .153).Conclusion:Increased serum Cys C is significantly associated with future stroke events in the elderly, especially in patients with carotid atherosclerosis. Thus, serum levels of Cys C could serve as a predicted biomarker for stroke attack.

Direct Quantification and Visualization of Homocysteine, Cysteine, and Glutathione in Alzheimer's and Parkinson's Disease Model Tissues.

Alzheimer's disease (AD) and Parkinson's disease (PD) are chronic neurodegenerative diseases with high morbidity and mortality. Homocysteine (Hcy), cysteine (Cys), and glutathione (GSH) are closely related to AD and PD. However, the dynamics of Hcy, Cys, and GSH in the brain tissues and the potential pathogenesis between Cys/Hcy/GSH with AD and PD remain unclear. Herein, a novel fluorescent probe 1 with multiple binding sites was rationally designed and exploited for the direct quantification of serum total Hcy and Cys along with superior optical properties. Importantly, differentiation and simultaneity fluorescence imaging of Cys, Hcy, and GSH dynamics were achieved in living cells, tissues, and mouse models of AD and PD with this probe, providing direct evidences for the relationship between Hcy/Cys/GSH and AD/PD for the first time. In addition, pathogenesis studies demonstrated that elevated Hcy and Cys levels are closely related to imbalanced redox homeostasis, increased amyloid aggregates, and nerve cell cytotoxicity. These findings will greatly promote the understanding of the functions of Hcy/Cys/GSH in Alzheimer's and Parkinson's diseases, demonstrating clinical promise for the early diagnosis and prevention of AD and PD.

Investigating Racial/Ethnic Disparities in the Association Between AHEI-2010 and Change in Cystatin C in a Representative Sample of Older Americans

ObjectivesCystatin C (Cys C) is a promising biomarker for early-stage chronic kidney disease. Dietary intake plays an essential role in the prevention of kidney function decline, which has yet to be examined in relation to changes in Cys C among older adults. Our objective was to test whether scores on the Alternative Healthy Eating Index-2010 (AHEI-2010) were associated with change in Cys C from 2012–2016 and if this varied by race/ethnicity. MethodsObservations were drawn from the Health and Retirement Study. Blood spot collection and examination occurred in 2012 and 2016, participant attributes were measured in 2012, and dietary assessment was conducted by a validated dietary frequency questionnaire in 2013. The sample was restricted to respondents aged ≥65 years who were White (n = 789), Black (n = 108), or Hispanic (n = 61) and had biomarkers measured in 2012 and 2016 (n = 958). Serum Cys C (mg/L) was constructed to be equivalent to the 1999–2002 NHANES scale. Dietary quality was measured using AHEI-2010. Autoregressive linear modeling adjusting for covariates and sampling design was used to examine the associations of interest. ResultsMean serum Cys C was 1.20 ± 0.44 mg/L (SD) in 2012 and 1.25 ± 0.45 mg/L in 2016, and mean AHEI-2010 score was 58.11 ± 11.0. Greater AHEI-2010 was associated with lower serum Cys C level at baseline (b = –.004, SE = .013, P = .002) and less rapid increase in the Cys C level from 2012–2016 (b = –.003, SE = .012, P = .024). The association between AHEI-2010 and change in serum Cys C was significantly different for Whites and Hispanics (b = .128, SE = .031, P < .001), but null when comparing Whites and Blacks. AHEI-2010 was negatively associated with change in Cys C for Whites, and positively associated with change in Cys C among Hispanics. Stratified analyses suggested that AHEI-2010 was not significantly different for Whites and Hispanics. Hispanics had significantly lower household income, assets, and educational attainment than Whites, and greater levels of food insecurity. ConclusionsOur results indicate that dietary quality has a divergent association with change in serum Cys C for White and Hispanic older adults. These results suggest the need for examination of how disparities in socioeconomic status may influence the effect of dietary intake on kidney function for older adults from different racial/ethnic backgrounds. Funding SourcesNo funding.

Correlation of serum cystatin C with inflammatory cytokines in patients with traumatic brain injury.

Traumatic brain injury (TBI) is a world-wide leading health problem with high morbidity and mortality rates. Emerging studies have demonstrated that TBI is the consequence of a series of inflammatory responses in the body. The alteration of Cystatin C (Cys C) was reported in a variety of chronic inflammatory diseases and was also recommended as a biomarker for predicting renal diseases. In this study, we aimed to investigate the relationship between serum Cys C and TBI, and to evaluate the prognostic role of Cys C in TBI prediction. One hundred and seventy-six patients with TBI were recruited and 102 patients were finally analyzed, with 30 healthy control subjects. The concentrations of Cys C were significantly reduced in the healthy control group compared to the TBI group, and correlated with high GCS scores. The levels of hsCRP, counts of white blood cells, and levels of IL-6 and TNF-α were remarkably elevated in the TBI patients compared with the control group in a severity-dependent manner. Moreover, the concentration of Cys C was negatively correlated with TBI severity and positively correlated with inflammatory factors. In conclusion, serum Cys is an inflammatory cytokine-related factor and might indicate the severity of TBI thus serving as a prognostic biomarker.

Serum cystatin C as a predictor of 90-day mortality among patients admitted with complications of cirrhosis.

Background and AimCystatin C (Cys) is not affected by age, sex, and muscle mass. We evaluated to compare the predictive performance of serum Cys level and model for end‐stage liver disease (MELD) score and developed a new model to predict 90‐day mortality among patients admitted with cirrhosis complications.MethodsA prospective cohort study was performed from December 2018 to December 2019. All cirrhotic patients admitted with acute decompensated liver cirrhosis or acute on chronic liver failure had laboratory values measured within 48 h of admission.ResultsA cohort of 225 patients with cirrhosis was admitted during the study period. Sixty‐five patients were eligible for analysis. Twenty‐seven of these patients (41.4%) died within 90 days of follow‐up. The median of MELD score was 20.5 (15, 24). Serum Cys level of >1.45 mg/L had the highest 90‐day mortality prediction with the sensitivity and specificity of 66.7% and 68.4%, respectively. Cys and MELD scores were predictive of 90‐day mortality: Cys hazard ratio (HR) = 2.04 (95% CI 1.01–4.14, P = 0.048); MELD score HR = 1.01 (95% CI 0.51–2.01, P = 0.970). C‐statistic of Cys, MELD score, model for end‐stage liver disease‐cystatin C (MELD‐Cys) score, combined Cys with MELD‐Cys score to predict 90‐day mortality were 0.67, 0.58, 0.58, and 0.63, respectively. Adding Cys to the MELD score did not improve the predictive of 90‐day mortality.ConclusionSerum Cys is superior to MELD score, and the new MELD‐Cys model is comparable to the MELD score in predicting mortality among patients with cirrhosis admitted with complications.

Research Progress on the Relationship between Serum Cystatin C and Heart Failure

Heart failure (HF) is caused by many factors that lead to myocardial damage, myocardial remodeling of ventricular overload, dysfunction of cardiac diastolic and systolic function, and insufficient blood volume of cardiac circulation. The process of myocardial remodeling is accompanied by myocardial cell ischemia, necrosis, apoptosis, progressive interstitial cell fibrosis and other pathological processes, which is a clinical syndrome in the final stage of various heart diseases, it has high morbidity and mortality, which is a serious threat to human health [1]. Early detection of HF and effective treatment to reduce its morbidity and mortality is particularly important. In recent years, it has been found that Cystatin C (Cys C) is closely related to the occurrence, development and prognosis of HF, and may be an independent predictor of HF. This article reviews the research progress on the relationship between serum Cys C and HF, as well as the pathogenesis, diagnosis, severity and prognosis of Cys C in HF.

Research Progress on the Relationship between Serum Cystatin C and Heart Failure

Heart failure (HF) is caused by many factors that lead to myocardial damage, myocardial remodeling of ventricular overload, dysfunction of cardiac diastolic and systolic function, and insufficient blood volume of cardiac circulation. The process of myocardial remodeling is accompanied by myocardial cell ischemia, necrosis, apoptosis, progressive interstitial cell fibrosis and other pathological processes, which is a clinical syndrome in the final stage of various heart diseases, it has high morbidity and mortality, which is a serious threat to human health [1]. Early detection of HF and effective treatment to reduce its morbidity and mortality is particularly important. In recent years, it has been found that Cystatin C (Cys C) is closely related to the occurrence, development and prognosis of HF, and may be an independent predictor of HF. This article reviews the research progress on the relationship between serum Cys C and HF, as well as the pathogenesis, diagnosis, severity and prognosis of Cys C in HF

Vitamin and mineral supplementation and rate of gain during the first trimester of gestation affect concentrations of amino acids in maternal serum and allantoic fluid of beef heifers.

The objective of this study was to evaluate the effects of feeding vitamin and mineral (VTM) supplement and (or) rate of gain (GAIN) during early gestation on amino acid (AA) concentrations in allantoic fluid (ALF) and amniotic fluid (AMF) and maternal serum. Seventy-two crossbred Angus heifers (initial BW = 359.5 ± 7.1 kg) were randomly assigned to one of four treatments in a 2 × 2 factorial arrangement with main effects of VTM supplement (VTM or NoVTM) and rate of gain (GAIN; low gain [LG], 0.28 kg/d, vs. moderate gain [MG], 0.79 kg/d). The VTM treatment (113 g•heifer-1•d-1, provided macro and trace minerals and vitamins A, D, and E to meet 110% of the requirements specified by the NASEM in Nutrient requirements of beef cattle. Washington, DC: The National Academies Press. doi:10.17226/19014, 2016) was initiated 71 to 148 d before artificial insemination (AI). To complete the factorial arrangement of treatments, at breeding heifers were either maintained on the basal diet (LG), or received MG diet which was implemented by adding a protein/energy supplement to the LG diet. Thirty-five gestating heifers with female fetuses were ovariohysterectomized on d 83 of gestation and maternal serum, ALF, and AMF were collected. Samples were analyzed for concentrations of neutral AA: Ala, Asn, Cys, Gln, Gly, Ile, Leu, Met, Phe, Pro, Ser, Thr, Trp, Tyr, and Val; cationic AA: Arg, His, and Lys; and anionic AA: Asp and Glu. In serum, a VTM × GAIN interaction (P = 0.02) was observed for Glu, with greater concentrations for VTM-LG than VTM-MG. Concentrations of serum Cys, Met, and Trp were greater (P ≤ 0.03) for MG than LG. In ALF, concentrations of Glu were affected by a VTM × GAIN interaction, where VTM-MG was greater (P < 0.01) than all other treatments. Further, ALF from VTM had increased (P ≤ 0.05) concentrations of His, Asp, and 12 of the 14 neutral AA; whereas GAIN affected concentrations of Arg, Cys, and Asp, with greater concentrations (P ≤ 0.05) in MG heifers. In AMF, AA concentrations were not affected (P ≥ 0.10) by VTM, GAIN, or their interaction. In conclusion, increased concentrations of AA in maternal serum and ALF of beef heifers were observed at d 83 of gestation in response to VTM supplementation and rate of gain of 0.79 kg/d, which raises important questions regarding the mechanisms responsible for AA uptake and balance between the maternal circulation and fetal fluid compartments.

Serum Cys C Assessment in Healthy Indian Population and Chronic Kidney Failure Individuals – A Case Control Study

Background Serum Cys C has been acknowledged as a simple and reliable biomarker for assessing renal function in research studies. Evolving evidence show its efficacy in improving the diagnostic approach when included in routine clinical practice. Objectives The study intended to evaluate and compare serum Cys C sCys C levels in healthy individuals with chronic kidney diseases.Materials and Methods A case control observational study was conducted at Padmashree Diagnostic Centre Vijayanagar Bengaluru. The sCys C test was assayed by latex enhanced immunoturbidometric method.Result Serum Cys C levels assessed in normal subjects was in the range of 1.03 plusmn 0.11 mgL comparable to the available reference interval for normal healthy population while sCys C values were between 3.55 and 4.71mgL with mean value of 4.3 mgL SDplusmn0.34 in chronic kidney patients. The results displayed significant increase in the values of serum Cys C in chronic kidney disease patients.Conclusion To conclude sCys C is a convenient diagnostic instrument for calculating the functional ability of the kidneys. Furthermore serum Cys C can be included in routine tests for clinical decision making and in the health care package for renal function.

FEASIBILITY OF CYSTATIN C DETERMINATION FOR EARLY DIAGNOSIS OF KIDNEY DAMAGE IN PATIENTS WITH TYPE 2 DIABETES COMBINED WITH NONALCOHOLIC FATTY LIVER DISEASE AND OBESITY EXPOSED TO COVID-19 INFECTION IN THE PAST

The aim: To examine the diagnostic possibilities of determining the level of cystatin C in the blood serum in order to ascertain the functional status of the kidneys in patients with type 2 diabetes (those who recovered from COVID-19 infection) depending on the presence or absence of non-alcoholic fatty liver disease (further – NAFLD) and malnutrition. Materials and methods: We investigated 18 patients with type 2 DM, who were included in the first group of the patients examined; group 2 consisted of 20 patients with type 2 DM and non-alcoholic fatty liver disease (NAFLD), namely with non-alcoholic steatohepatitis; and group 3 of the patients examined consisted of 30 patients with type 2 DM and obesity. Results: Renal damage in patients with metabolically associated diseases in the background of respiratory disease due to COVID-19 infection was also indicated by changes in urine test indicators, and namely – proteinuria and erythrocyturia, leukocyturia in urine sediment. The examination of cystatin C (Cys C) level indicates its statistically significant increase in patients of all examined groups, with the highest levels established in group 3 patients (with its increase up to 2.58 ± 0.11 mg/L, compared with the norm of 0.75 ± 0.04 mg/L in the control group – p &lt; 0.01). The examination of GFR by calculation, where the Cys C index in serum was used, revealed a significant decrease in this parameter in all the examined groups of patients. At the same time, the maximum values were found in group 1 patients (65.7 ± 1.4 ml/min per 1.73 m2 of the body surface), and the minimum values – in group 3 patients (48.3 ± 2.7 ml/min per 1.73 m2 of the body surface). Conclusions: An increase in serum cystatin C levels was determined in type 2 diabetes patients, with the lowest level in group 1 patients (1.24 ± 0.07 mg/L – p &lt; 0.05), and the highest level in patients suffering from type 2 diabetes combined with NAFLD and obesity (2.58 ± 0.11 mg/L – p &lt; 0.01). A moderate to severe course of COVID-19 infection in patients with type 2 diabetes as well as with its combination with NAFLD and obesity contributes to the development of renal functional disorders in these patients. Moreover, an increase in serum Cys C levels is a more sensitive and earlier marker of renal damage development in comorbid pathology.

218 Effects of feeding a vitamin and mineral supplement and (or) an energy supplement on concentrations of amino acids in beef heifer serum and fetal fluids at d 83 of gestation

Abstract Objectives were to evaluate effects of feeding vitamin and mineral (VTM) and (or) energy (NRG) supplements on concentrations of amino acids (AA) in heifer serum and allantoic (ALF) and amniotic (AMF) fluids at d 83 of gestation. Thirty-five crossbred Angus heifers (body weight = 359.5 ± 7.1 kg) were randomly assigned to one of four treatments (n = 8 or 9/group) in a 2 × 2 factorial arrangement with main effects of vitamin and mineral (NoVTM or VTM) and energy (NoNRG or NRG) supplements. Heifers were fed a basal total mixed ration once daily with VTM and NRG treatments top-dressed. The VTM treatment (113 g•heifer-1•d-1) was initiated 71 to 148 d before artificial insemination (AI). The NRG treatment was initiated at AI targeting gains of 0.28 kg/d for NoNRG and 0.79 kg/d for NRG. Serum, ALF, and AMF were collected at d 83 ± 0.27 of gestation and analyzed for concentrations of AA. In serum, a VTM × NRG interaction (P = 0.02) was observed for Glu, with greater concentrations for VTM-NoNRG than VTM-NRG. Concentrations of serum Cys, Met, and Trp were greater (P ≤ 0.03) for NRG than No-NRG. In ALF, concentrations of Glu were affected by a VTM × NRG interaction, where VTM-NRG was greater (P &amp;lt; 0.01) than all others. In ALF, VTM increased (P ≤ 0.05) concentrations of His, Asp, and 12 of the 14 neutral AA, whereas NRG increased (P ≤ 0.05) Arg, Cys, and Asp. In AMF, AA concentrations were not affected (P ≥ 0.10) by VTM, NRG, or their interaction. In conclusion, an increase in neutral AA concentration in ALF from beef heifers was observed at d 83 of gestation with VTM supplementation, suggesting effects on the mechanisms of AA uptake and balance between the maternal circulation and fetal fluid compartments.

Correlation analysis of serum cystatin C, uric acid and lactate dehydrogenase levels before chemotherapy on the prognosis of small-cell lung cancer.

Related studies have reported that cystatin C (Cys C), uric acid (UA) and lactate dehydrogenase (LDH) affect tumor growth and invasion; however, the correlation between them and the prognosis of patients with small-cell lung cancer (SCLC) remains unclear. The present study aimed to investigate the effects of serum Cys C, UA and LDH concentrations on the prognosis of patients with SCLC prior to initial treatment, in order to identify potential targets for determining the clinical outcome of patients with SCLC. A total of 205 patients with SCLC were enrolled in the present study, and the clinical and laboratory data were obtained from the medical records. The receiver operating characteristic curve was used to determine the optimal cut-off values of Cys C, UA and LDH, while the Kaplan-Meier method was used for survival analysis. The Cox proportional hazard model was used for univariate and multivariate analyses to identify independent prognostic factors. The optimal cut-off values for Cys C, UA and LDH were 0.775 mg/l, 296.45 µmol/l and 198.5 U/l, respectively. The survival curves demonstrated that progression-free survival (PFS) and overall survival (OS) time were shorter in patients with high levels of Cys C, UA and LDH prior to chemotherapy. Univariate and multivariate analyses indicated that LDH concentration prior to chemotherapy may be an independent prognostic factor for both PFS and OS in patients with SCLC, while Cys C concentration may be an independent prognostic factor for PFS in patients with SCLC. The concentrations of Cys C, UA and LDH prior to chemotherapy were associated with prognosis of patients with SCLC. PFS and OS time were shorter, and the prognosis was poor in patients with elevated serum levels of Cys C, UA and LDH. Taken together, the results of the present study suggest that high concentrations of LDH and Cys C prior to chemotherapy may indicate rapid disease progression, thus it is important to focus on the progression and recurrence of the disease. High LDH concentration may also indicate a shorter survival time.