@article{oai:twinkle.repo.nii.ac.jp:00019253,
 author = {OTSUBO, Yuriko and NITTA, Kosaku and UCHIDA, Keiko and YUMURA, Wako and NIHEI, Hiroshi},
 issue = {5},
 journal = {東京女子医科大学雑誌},
 month = {May},
 note = {IgA腎症患者の糸球体濾過値(GFR)のマーカーとして,シスタチンCとクレアチニンの血清濃度(Scyst vs. Screat)を比較した.対象は,臨床的および病理学的にIgA腎症と診断された179例である.平均年齢は34.2±11.5歳で,男女比は男性:女性=67:112であった.標準GFR測定法として,イヌリン・クリアランス(Cin)を施行し,Cin値により対象を4群(I群:Cin<30ml/min/1.48m^2, II群:30<Cin<60ml/min/1.48m^2, III群:60<Cin<90ml/min/1.48m^2, IV群:90ml/min/1.48m^2<Cin)に分けた.Scystはlatex immunonephelometry法で, Screatは酵素法で測定した.他のGFR関連マーカーとして,β_2-ミクログロブリン(β_2-m)とα_1-ミクログロブリン(α_1-m)も同時に測定した.病理学的指標として,糸球体硬化率と間質線維化度を用いた. ScystおよびScreatのカットオフ値は,それぞれ 1.0mg/lと1.3mg/dlであった. Cinとの相関係数は, 1/Scyst (r=0.738), 1/Screat (r=0.582), 1/β_2-m (r=0.651)および1/α_1-m (r=0.558)で, Scystで最も相関性が高かった. Scystとの相関係数は, Screat (r=0.892),β_2-m (r=0.832)およびα_1-m(r=0.846)とほぼ同等であった. Cin値で4群に分けて, ScystとScreat濃度の変化と糸球体硬化度および間質線維化度との関係を比較したが,有意な関連性は見出せなかった. Cin=60ml/minを基準としたROC曲線による解析では, Screat曲線下面積(0.7955±0.0348)に比し, Scyst曲線下面積(0.8698±0.0286)は有意に広く(p=0.0002),診断の特異性および感受性が優れていることが判明した.これらの結果より, IgA腎症においては, ScreatよりScystがより正確にGFRを反映していると考えられた., Serum cystatin C (Scyst) has been proposed as a novel indicator of glomerular filtration rate (GFR). The present study was performed to evaluate practical use of a commercially available kit to measure Scyst as a new marker of GFR in patients with IgA nephropathy. A total of 179 patients aged 34.2 ± 11.5 years (male/female: 67/112) were enrolled in this study. We simultaneously measured the Scyst levels and other GFR markers such as inulin clearance (Cin) and serum levels of β_2 and α_1-microglobulin. A highly significant correlation was found between Scyst and serum creatinine (Screat) (r=0.892, p<0.0001), and Scyst and Cin (r=0.738, p<0.0001). No significant difference was detected in the correlation coefficient in glomerulosclerosis rate and Scyst or Screat. There were no significant changes in Scyst and Screat when the extent of interstitial fibrosis increased. The area under the receiver operating characteristics (ROC) curve was significantly greater for Scyst than for Screat (p=0.0002). This study suggests that Scyst is more sensitive than Screat for detecting a mild renal impairment and Scyst could be proposed as a confirmatory test for IgA nephropathy patients with elevated Screat},
 pages = {256--263},
 title = {Comparison of Serum Concentrations of Cystatin C versus Creatinine in Patients with IgA Nephropathy},
 volume = {74},
 year = {2004}
}