Cystatin C serum levels in healthy children are related to age, gender, and pubertal stage

Abstract

BackgroundThis study aims to establish age- and gender-specific cystatin C (CysC) reference values for healthy infants, children, and adolescents and to relate them to pubertal stage, height, weight, and body mass index (BMI).MethodsSerum CysC and creatinine levels of 6217 fasting, morning venous blood samples from 2803 healthy participants of the LIFE Child study (age 3 months to 18 years) were analyzed by an immunoassay. Recruitment started in 2011; 1636 participants provided at least one follow-up measurement. Percentiles for CysC were calculated. Age- and gender-related effects of height, weight, BMI, and puberty status were assessed through linear regression models.ResultsOver the first 2 years of life, median CysC levels decrease depending on height (ß = − 0.010 mg/l/cm, p < 0.001) and weight (ß = − 0.033 mg/l/kg, p < 0.001) from 1.06 to 0.88 mg/l for males and from 1.04 to 0.87 mg/l for females. Following the second year of age, the levels remain stable for eight years. From 11 to 14 years of age, there is an increase of median CysC levels in males to 0.98 mg/l and a decrease in females to 0.86 mg/l. The change is associated with puberty (ß = 0.105 mg/l/Tanner stage, p < 0.001 in males and ß = − 0.093 mg/l/Tanner stage, p < 0.01 in females) and in males with height (ß = 0.003 mg/l/cm, p < 0.001).ConclusionsCysC levels depend on age, gender, and height, especially during infancy and puberty. We recommend the use of age- and gender-specific reference values for CysC serum levels for estimating kidney function in clinical practice.Electronic supplementary materialThe online version of this article (10.1007/s00467-018-4087-z) contains supplementary material, which is available to authorized users.

Relation of Whole Blood Amino Acid and Acylcarnitine Metabolome to Age, Sex, BMI, Puberty, and Metabolic Markers in Children and Adolescents

“…To our best knowledge, only a few studies are available that examine circulating levels of CysC under physiological conditions in children. Age-dependent reference ranges up to the age of 18 have been published by Ziegelasch et al [22]. In addition to being a marker for kidney function, CysC is involved in several pathophysiological processes.…”

“…Age-and sex-adjusted SDS values for all AAs and ACs, for creatinine, glucose, and for HbA1c were calculated using the sds-function "childsds" in the R-package [37,40]. The relative references for triglycerides, total cholesterol, LDL-C, HDL-C, AST, ALT, and CysC have been previously published [22,41,42]. References for the thyroid hormones (TSH, FT3, and FT4) are still unpublished and were also estimated using the LMS method.…”

A case of congenital tuberculosis with a favorable outcome in a full term neonate

“…Brain magnetic resonance imaging (MRI) showed no sign of meningitis, whereas abdominal MRI showed enlarged mesenteric lymph nodes and hepatosplenomegaly (Figure 2). Her serum ALT, AST, and cystatin C were elevated to 1350 nmol/L, 2817 nmol/L, and 2.03 mg/L (normal: <667 nmol/L, <833 nmol/L, and <1.5 mg/L, respectively) 6 . Serum bilirubin level was 56 µmol/L (of which conjugated was 42 µmol/L).…”

“…Her serum ALT, AST, and cystatin C were elevated to 1350 nmol/L, 2817 nmol/L, and 2.03 mg/L (normal: <667 nmol/L, <833 nmol/L, and <1.5 mg/L, respectively). 6 Serum bilirubin level was 56 µmol/L (of which conjugated was 42 µmol/L). Lactate dehydrogenase was 15 µmol/L (2.3-6.3 µmol/L), and Coombs test was negative.…”

Folate and Cobalamin Serum Levels in Healthy Children and Adolescents and Their Association with Age, Sex, BMI and Socioeconomic Status

“…Additional details regarding the study design are provided elsewhere [ 20 , 21 ]. The LIFE Child cohort has served to establish pediatric reference ranges in prior studies, e.g., regarding liver enzymes [ 22 ] and cystatin C [ 23 ].…”