BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.Howeve...BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.展开更多
Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria ...Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analysis further supported the efficacy of serum Cystatin C, with an Area under the ROC Curve of 0.864 and a cut-off value of 0.55 (p Conclusion: This study supports the superior utility of serum Cystatin C as an early detector of AKI in on-pump cardiac surgery patients compared to serum creatinine. Its ability to identify AKI several hours earlier may contribute to reduced morbidity, mortality, and healthcare costs. The findings underscore the significance of exploring novel biomarkers for improved post-cardiac surgery renal function assessment.展开更多
BACKGROUND： Serum creatinine （SCr） is the most commonly used parameter to estimate renal function impairement, but there are some shortcomings. Many factors including age, gender, drug, diet, muscle mass and metabo...BACKGROUND： Serum creatinine （SCr） is the most commonly used parameter to estimate renal function impairement, but there are some shortcomings. Many factors including age, gender, drug, diet, muscle mass and metabolic rate can in？ uence SCr, leading to an inaccurate estimation of kidney impairment. Studies have shown that cystatin C （CysC） is not affected by factors such as muscle mass, age, gender, diet, in？ ammation or tumor. The present study was undertaken to compare the sensitivity of CysC and SCr in evaluating renal function impairment at early stage of shock.METHODS： Seventy-one patients aged 38.3±21.4 years, who had been treated at the Emergency Medicine Department of the First Affiliated Hospital, Sun Yat-sen University between February 2006 and June 2007, were studied. They were divided into groups A, B, C, and D according to the shock time. Serum sample was drawn from each patient at 1, 2, 3, 4 hours after shock to determine SCr and CysC. CysC and SCr were determined again at 72 hours and 7 days after shock.RESULTS： CysC increased earlier than SCr in the 71 patients, and CysC decreased slower than SCr when shock was corrected. CysC increased at 1 hour after shock. There was a negative correlationship between CysC, SCr and glomerular filtration rate （GFR）, especially at early stage of shock.CONCLUSIONS： There is renal injury at early stage of shock. CysC is more sensitive than SCr in assessing renal function at the early stage of shock.展开更多
目的 探究黄葵胶囊联合达格列净对早期糖尿病肾病患者胱抑素C(Cys-C)、α1-微球蛋白(α1-MG)的影响。方法 115例早期糖尿病肾病患者,依据随机数字表法将其分为达格列净组(35例)、黄葵胶囊组(38例)、联合组(42例)。达格列净组给予达格列...目的 探究黄葵胶囊联合达格列净对早期糖尿病肾病患者胱抑素C(Cys-C)、α1-微球蛋白(α1-MG)的影响。方法 115例早期糖尿病肾病患者,依据随机数字表法将其分为达格列净组(35例)、黄葵胶囊组(38例)、联合组(42例)。达格列净组给予达格列净治疗,黄葵胶囊组给予黄葵胶囊治疗,联合组给予黄葵胶囊联合达格列净治疗。对比三组治疗前后血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、炎性因子[可溶性细胞间黏附分子1(sICAM-1)、高迁移率族蛋白B1(HMGB1)、单核细胞趋化蛋白1(MCP-1)]、胱抑素C(Cys-C)、α1-微球蛋白(α1-MG)水平。结果 治疗后,达格列净组FBG为(6.79±0.96)mmol/L、2 h PG为(10.12±2.07)mmol/L、HbA1c为(7.03±1.02)%;黄葵胶囊组FBG为(6.64±0.91)mmol/L、2 h PG为(9.34±1.96)mmol/L、HbA1c为(6.71±0.94)%;联合组FBG为(5.60±0.76)mmol/L、2 h PG为(5.65±1.13)mmol/L、HbA1c为(6.03±0.62)%。治疗后,三组FBG、2 h PG、HbA1c水平均低于本组治疗前,且联合组FBG、2 h PG、HbA1c水平均低于达格列净组与黄葵胶囊组,差异均有统计学意义(P<0.05)。治疗后,达格列净组s ICAM-1为(168.94±24.74)μg/L、HMGB1为(10.39±1.95)μg/L、MCP-1为(155.49±14.50)ng/L;黄葵胶囊组s ICAM-1为(153.28±23.11)μg/L、HMGB1为(9.41±1.84)μg/L、MCP-1为(146.23±13.73)ng/L;联合组sICAM-1为(102.38±22.74)μg/L、HMGB1为(5.20±1.25)μg/L、MCP-1为(132.87±15.75)ng/L。治疗后,三组sICAM-1、HMGB1、MCP-1水平均低于本组治疗前,且联合组s ICAM-1、HMGB1、MCP-1水平均低于达格列净组与黄葵胶囊组,差异均有统计学意义(P<0.05)。治疗后,达格列净组Cys-C为(2.03±0.48)mg/L、尿α1-MG为(13.45±2.16)mg/L;黄葵胶囊组Cys-C为(1.92±0.51)mg/L、尿α1-MG为(12.67±2.01)mg/L;联合组Cys-C为(1.06±0.35)mg/L、尿α1-MG为(8.42±1.73)mg/L。治疗后,三组Cys-C、尿α1-MG水平均低于本组治疗前,且联合组Cys-C、尿α1-MG水平均低于达格列净组与黄葵胶囊组,差异均有统计学意义(P<0.05)。结论 黄葵胶囊联合达格列净治疗早期糖尿病肾病患者疗效显著,血糖水平逐渐降低、恢复,机体炎症情况减轻,肾功能得到有效保护,值得临床推广应用。展开更多
文摘BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.
文摘Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analysis further supported the efficacy of serum Cystatin C, with an Area under the ROC Curve of 0.864 and a cut-off value of 0.55 (p Conclusion: This study supports the superior utility of serum Cystatin C as an early detector of AKI in on-pump cardiac surgery patients compared to serum creatinine. Its ability to identify AKI several hours earlier may contribute to reduced morbidity, mortality, and healthcare costs. The findings underscore the significance of exploring novel biomarkers for improved post-cardiac surgery renal function assessment.
文摘BACKGROUND： Serum creatinine （SCr） is the most commonly used parameter to estimate renal function impairement, but there are some shortcomings. Many factors including age, gender, drug, diet, muscle mass and metabolic rate can in？ uence SCr, leading to an inaccurate estimation of kidney impairment. Studies have shown that cystatin C （CysC） is not affected by factors such as muscle mass, age, gender, diet, in？ ammation or tumor. The present study was undertaken to compare the sensitivity of CysC and SCr in evaluating renal function impairment at early stage of shock.METHODS： Seventy-one patients aged 38.3±21.4 years, who had been treated at the Emergency Medicine Department of the First Affiliated Hospital, Sun Yat-sen University between February 2006 and June 2007, were studied. They were divided into groups A, B, C, and D according to the shock time. Serum sample was drawn from each patient at 1, 2, 3, 4 hours after shock to determine SCr and CysC. CysC and SCr were determined again at 72 hours and 7 days after shock.RESULTS： CysC increased earlier than SCr in the 71 patients, and CysC decreased slower than SCr when shock was corrected. CysC increased at 1 hour after shock. There was a negative correlationship between CysC, SCr and glomerular filtration rate （GFR）, especially at early stage of shock.CONCLUSIONS： There is renal injury at early stage of shock. CysC is more sensitive than SCr in assessing renal function at the early stage of shock.
文摘目的 探究黄葵胶囊联合达格列净对早期糖尿病肾病患者胱抑素C(Cys-C)、α1-微球蛋白(α1-MG)的影响。方法 115例早期糖尿病肾病患者,依据随机数字表法将其分为达格列净组(35例)、黄葵胶囊组(38例)、联合组(42例)。达格列净组给予达格列净治疗,黄葵胶囊组给予黄葵胶囊治疗,联合组给予黄葵胶囊联合达格列净治疗。对比三组治疗前后血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、炎性因子[可溶性细胞间黏附分子1(sICAM-1)、高迁移率族蛋白B1(HMGB1)、单核细胞趋化蛋白1(MCP-1)]、胱抑素C(Cys-C)、α1-微球蛋白(α1-MG)水平。结果 治疗后,达格列净组FBG为(6.79±0.96)mmol/L、2 h PG为(10.12±2.07)mmol/L、HbA1c为(7.03±1.02)%;黄葵胶囊组FBG为(6.64±0.91)mmol/L、2 h PG为(9.34±1.96)mmol/L、HbA1c为(6.71±0.94)%;联合组FBG为(5.60±0.76)mmol/L、2 h PG为(5.65±1.13)mmol/L、HbA1c为(6.03±0.62)%。治疗后,三组FBG、2 h PG、HbA1c水平均低于本组治疗前,且联合组FBG、2 h PG、HbA1c水平均低于达格列净组与黄葵胶囊组,差异均有统计学意义(P<0.05)。治疗后,达格列净组s ICAM-1为(168.94±24.74)μg/L、HMGB1为(10.39±1.95)μg/L、MCP-1为(155.49±14.50)ng/L;黄葵胶囊组s ICAM-1为(153.28±23.11)μg/L、HMGB1为(9.41±1.84)μg/L、MCP-1为(146.23±13.73)ng/L;联合组sICAM-1为(102.38±22.74)μg/L、HMGB1为(5.20±1.25)μg/L、MCP-1为(132.87±15.75)ng/L。治疗后,三组sICAM-1、HMGB1、MCP-1水平均低于本组治疗前,且联合组s ICAM-1、HMGB1、MCP-1水平均低于达格列净组与黄葵胶囊组,差异均有统计学意义(P<0.05)。治疗后,达格列净组Cys-C为(2.03±0.48)mg/L、尿α1-MG为(13.45±2.16)mg/L;黄葵胶囊组Cys-C为(1.92±0.51)mg/L、尿α1-MG为(12.67±2.01)mg/L;联合组Cys-C为(1.06±0.35)mg/L、尿α1-MG为(8.42±1.73)mg/L。治疗后,三组Cys-C、尿α1-MG水平均低于本组治疗前,且联合组Cys-C、尿α1-MG水平均低于达格列净组与黄葵胶囊组,差异均有统计学意义(P<0.05)。结论 黄葵胶囊联合达格列净治疗早期糖尿病肾病患者疗效显著,血糖水平逐渐降低、恢复,机体炎症情况减轻,肾功能得到有效保护,值得临床推广应用。
