Serum levels of beta-trace protein and glomerular filtration rate—preliminary results

Donadio, Carlo; Lucchesi, Annalisa; Ardini, Michela; Donadio, Elena; Giordani, Roberto

doi:10.1016/s0731-7085(03)00215-2

Cited by 48 publications

(43 citation statements)

References 25 publications

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“…Serum b-trace protein increases with reduction in GFR, and has a linear correlation with serum creatinine [17], as our findings confirmed. Markedly elevated levels have been found in patients with end-stage renal failure [20], and thus the CSF : serum ratio is likely to be different in patients with renal impairment.…”

Section: Discussionsupporting

confidence: 87%

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Cerebrospinal fluid and serum concentrations of beta‐trace protein during pregnancy

McArthur

Hill²,

Paech

et al. 2005

Anaesthesia

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SummaryWe conducted a prospective observational study among a cohort of 40 term parturients undergoing spinal anaesthesia for elective Caesarean section, to determine the concentration of b-trace protein in cerebrospinal fluid (CSF) and serum. Serum and CSF samples, taken at the time of dural puncture, were assayed by nephelometry. The mean serum b-trace protein concentration was 0.39 mg.l )1 and the mean CSF concentration was 27.9 mg.l )1 , giving a mean ratio of CSF to serum concentration of 76. This ratio is higher than that published for non-pregnant females and for males because of both a higher mean CSF and a lower mean serum b-trace protein concentration. The concentration correlated positively with both serum creatinine and gestational age. If these concentrations are used to estimate the normal range, we propose that the nephelometric measurement of b-trace protein might prove a useful diagnostic test for cerebrospinal fluidcutaneous fistula in parturients. Reports of cerebrospinal fluid-cutaneous fistulae (CSFCF) complicating epidural anaesthesia are uncommon [1]. However, in our experience, fluid leakage at the site of epidural needle insertion for combined spinal-epidural anaesthesia is not uncommon [2]. A fast and accurate test to detect CSF in such fluid would be valuable, given concern that meningitis might complicate the clinical picture [3]. The nephelometric assay of b-trace protein is considered the best method of detecting CSF rhinorrhoea and otorrhoea [4], and concentrations of serum and CSF b-trace protein have been determined for healthy male and female patients. However, the CSF concentration of b-trace protein has not been studied in the pregnant population. b-trace protein (prostaglandin D synthase) is an abundant brain-specific protein, comprising about 3% of the total CSF protein [5]. It is synthesised by both the choroid plexus and the leptomeninges [4], and is normally found in CSF in concentrations 35 times higher than in serum. This ratio is the highest of all the CSF-specific proteins, making b-trace protein an ideal marker for the detection of CSF [6,7].

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Section: Discussionsupporting

confidence: 87%

“…Donadio et al studied 120 patients and found the mean serum concentration significantly lower in females [17]. Male patients have higher CSF b-trace protein concentrations, possibly due to differences in the CSF : serum albumin ratio [7,18].…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid and serum concentrations of beta‐trace protein during pregnancy

McArthur

Hill²,

Paech

et al. 2005

Anaesthesia

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“…Whereas some studies describe higher bTP concentrations in adult men compared with women (35), most studies have shown no sex differences in children (29,30). b2M has not been shown to differ by sex in youth (29), but some studies have reported higher b2M concentrations in adult men compared with women (33), whereas others report no sex differences (31,32).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Serum Concentrations of β-Trace Protein, β2-Microglobulin, Cystatin C, and Creatinine in the US Population

Juraschek

Coresh

Inker

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives b-trace protein (bTP), b2-microglobulin (b2M), and cystatin C (CysC) have advantages over creatinine for estimating GFR and prognosis. This study compares the distribution of all four markers in the general population and their associations with possible determinants of GFR.Design, setting, participants, & measurements bTP and b2M were measured in 7596 participants (aged $12 years) of the Third National Health and Nutrition Examination Survey (1988)(1989)(1990)(1991)(1992)(1993)(1994). bTP and b2M concentrations and the proportion of persons with elevated ($99th percentile for young healthy participants) bTP ($0.81 mg/L), b2M ($2.80 mg/L), standardized CysC ($1.03 mg/L), and creatinine ($1.2 mg/dl for men and $1.0 mg/dl for women) were compared across demographic and clinical factors.Results Elevated bTP, b2M, and CysC showed stronger associations with age than elevated serum creatinine, the prevalence of elevated levels reaching 47%, 44%, 58%, and 26%, respectively, by age 80 years. bTP, CysC, and creatinine were higher in men but b2M was not associated with sex. Mexican Americans had lower bTP, b2M, CysC, and creatinine compared with non-Hispanic whites. Hypertension and higher C-reactive protein were associated with elevations in all markers, whereas non-Hispanic black race, body mass index, diabetes, smoking status, triglycerides, HDL cholesterol, and education were not associated in a consistent manner across the different markers.Conclusions bTP, b2M, CysC, and creatinine differ in their associations with demographic and clinical factors, suggesting variation in their non-GFR determinants. Future studies should examine these markers with measured GFR to determine their diagnostic and prognostic utility.

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“…[11][12][13][14][15] BTP is a low molecular weight glycoprotein that is freely filtered by the glomerulus, and has minimal nonkidney elimination. 14 Some studies have suggested that BTP is more accurate than creatinine in estimating measured GFR 11,[13][14][15][16][17][18][19][20][21] and is more strongly associated with CVD. 22 It is unclear whether the stronger associations of cystatin C and BTP with outcomes are due to more accurate GFR estimation or to confounding by non-GFR effects.…”

mentioning

confidence: 99%

Filtration Markers May Have Prognostic Value Independent of Glomerular Filtration Rate

Tangri

Inker

Tighiouart

et al. 2012

Journal of the American Society of Nephrology

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Serum levels of creatinine, cystatin C, or b trace protein allow estimation of GFR, but whether these markers contribute additional prognostic information beyond that reflected in GFR is unknown. Here, we analyzed data from the Modification of Diet in Renal Disease study, which provided baseline levels of these markers for 816 participants with a median follow-up of 16.6 years. We examined associations between the reciprocals of these filtration markers and 125 I iothalamate GFR, expressed per SD, with kidney failure and mortality. In univariate analysis, lower GFR and higher levels of each filtration marker associated with a higher risk for all outcomes. After adjustment for GFR in a Cox proportional hazards model, higher creatinine associated with a higher risk for kidney failure but a lower risk for all-cause mortality. Higher cystatin C and b trace protein associated with a higher risk for both kidney failure and all-cause mortality. In models including either cystatin C or b trace protein, the association of GFR with all-cause mortality was no longer significant after the addition of the filtration marker, suggesting the possibility of multicollinearity. In summary, after adjustment for GFR, levels of creatinine, cystatin C, and b trace protein, each remained directly associated with kidney failure but differed with respect to their associations with mortality. These differences may be a result of non-GFR-related associations of filtration markers, residual confounding by GFR, or collinearity between the filtration markers and GFR. b trace protein and cystatin C seem to provide more consistent prognostic information than creatinine.

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Serum levels of beta-trace protein and glomerular filtration rate—preliminary results

Cited by 48 publications

References 25 publications

Cerebrospinal fluid and serum concentrations of beta‐trace protein during pregnancy

Cerebrospinal fluid and serum concentrations of beta‐trace protein during pregnancy

Comparison of Serum Concentrations of β-Trace Protein, β2-Microglobulin, Cystatin C, and Creatinine in the US Population

Filtration Markers May Have Prognostic Value Independent of Glomerular Filtration Rate

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