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. 2018 Dec 1;37(4):434-440.
doi: 10.1515/jomb-2017-0064. eCollection 2018 Dec.

Serum Cystatin C Levels in COPD: Potential Diagnostic Value and Relation between Respiratory Functions

Selda Telo  1 , Mutlu Kuluöztürk  2 , Figen Deveci  3 , Gamze Kırkıl  3 , Önsel Öner  3 , Dilara Kaman  1
Affiliations

Serum Cystatin C Levels in COPD: Potential Diagnostic Value and Relation between Respiratory Functions

Selda Telo et al. J Med Biochem. .

Abstract
in English, Serbian

Background: The aim of this study was to determine the level of serum cystatin C (CysC) in patients with Chronic Obstructive Pulmonary Disease (COPD) during exacerbation and stable periods and to investigate its potential diagnostic value and the relationship between CysC levels and the pulmonary function test (PFT).

Methods: One hundred twenty-six patients with COPD (68 in stable periods, 58 during exacerbation periods) and 50 healthy subjects were included in the study. PFT, body mass index (BMI), white blood cell counts, C-reactive protein (CRP), serum urea and creatinine levels were evaluated in both groups of patients. CysC levels were measured in all participants.

Results: Serum CysC levels were statistically higher in both COPD groups than the control group (p<0.001 for both) although there was no statistically significant difference between COPD groups (p>0.05). CysC levels showed negative correlation with forced expiratory volume in 1 second (FEV1) and a positive correlation with C-reactive protein (CRP) levels in patients with stable COPD. There was a positive correlation between serum CysC levels and serum urea, creatinine, CRP levels in patients with COPD exacerbation (r=0.333, p=0.011; r=0.260, p=0.049; r=0.414, p<0.01 respectively). When stable COPD and control groups were evaluated, serum CysC had an area under the curve (AUC) in the receiver operating characteristic (ROC) curve of 0.951 (0.909-0.994 95% CI: p<0.001).

Conclusions: Our results showed that CysC levels increased in both COPD groups. Increased CysC levels may be related with lung function decline and inflammation in COPD patients. In addition, CysC levels may be a potential indicator for the diagnosis of COPD.

Uvod: Cilj ove studije bio je da se odredi nivo cistatina C (CysC) u serumu pacijenata sa hroničnom opstruktivnom bolešću pluća (HOBP) tokom perioda pogoršanja i u stabilnoj fazi bolesti i da se ispita njegova potencijalna dijagnostička vrednost kao i odnos između nivoa CysC i testa plućne funkcije (PFT).

Metode: Sto dvadeset šest pacijenata sa HOBP (68 u stabilnoj fazi, 58 tokom perioda pogoršanja) i 50 zdravih subjekata je uključeno u ovu studiju. PFT, indeks telesne mase (ITM), ukupan broj leukocita, C-reaktivni protein (CRP), nivoi uree i kreatinina u serumu određeni su u obe grupe pacijenata. Nivoi CysC izmereni su kod svih učesnika.

Rezultati: Serumski nivoi CysC bili su statistički viši u obe grupe sa HOBP nego u kontrolnoj grupi (p<0,001 za oba) iako nije bilo statistički značajne razlike između grupa sa HOBP (p>0,05). Nivoi CysC bili su u negativnoj korelaciji sa FEV1 i u pozitivnoj korelaciji sa nivoima C-reaktivnog proteina (CRP) kod pacijenata sa stabilnom HOBP. Nađena je pozitivna korelacija između serumskih nivoa CysC i uree, kreatinina, nivoa CRP u serumu kod pacijenata sa pogoršanjem HOBP (r=0,333, p=0,011; r=0,260, p=0,049; r=0,414, p<0,001). Prilikom poređenja grupe sa stabilnom HOBP i kontrolne grupe, serumski CysC imao je površinu ispod ROC krive od 0,951 (0,909–0,994 95% CI: p<0,001).

Zaključak: Naši rezultati pokazuju da su nivoi CysC bili povišeni u obe grupe sa HOBP. Povišeni nivoi CysC možda su povezani sa smanjenjem plućne funkcije i inflamacijom kodobolelih od HOBP. Pored toga, nivoi CysC mogu biti potencijalni pokazatelj za dijagnozu HOBP.

Keywords: COPD; cystatin C; pulmonary function.

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Conflict of interest statement

Conflict of interest statement The authors stated that they have no conflicts of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
Serum CysC levels in the study population.
Figure 2
Figure 2
Correlations between CysC and forced expiratory volume in 1 s (FEV1) and C-reactive protein (CRP) and smoking in stable COPD patients.
Figure 3
Figure 3
Correlations between CysC and urea, creatinine, CRP and smoking levels in exacerbation group.
Figure 4
Figure 4
A; A cut-off level of CysC in stable COPD patients and control group. B; Receiver operating characteristic (ROC) curve indicating sensitivity and specificity of CysC to diagnose COPD.
See this image and copyright information in PMC

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