Change of cystatin C values in preterm infants with asphyxia-From two centers of China

J Clin Lab Anal. 2017 Sep;31(5):e22070. doi: 10.1002/jcla.22070. Epub 2016 Oct 31.

Abstract

Background: To explore the values of cystatin C (Cys-C) in asphyxial preterm babies as an effective endogenous marker of renal function.

Methods: After birth, preterm infants with 5-minute Apgar score <8 were included into the asphyxia group. Finally, 276 preterm infants born in two neonatal intensive care units were studied (including 78 babies in the asphyxia group and 198 babies in the control group). Blood samples were obtained from peripheral veins on day 1, day 7, and day 28 when routine blood screening tests were performed.

Results: In first day samples, the mean levels of Cys-C were 2.21 (1.49-2.98) mg/L with gestational age (GA) >32, 1.94 (1.37-2.76) mg/L with GA 28-32, and 1.87 (1.49-2.13) mg/L with GA <28 in the asphyxia group. In seventh day samples, the mean levels of Cys-C were 2.35 (1.57-3.26) mg/L with GA>32, 2.07 (1.42-2.90) mg/L with GA 28-32, and 1.69 (1.13-2.04) mg/L with GA <28. In twenty-eighth day samples, the mean levels of Cys-C were 1.92 (1.61-2.13) mg/L with GA>32, 1.79 (1.29-1.84) mg/L with GA 28-32, and 1.66 (1.21-2.10) mg/L GA <28. There were significant differences not only between the asphyxia and control groups, but also between the mild, moderate, and severe asphyxia groups.

Conclusion: Cys-C has a good distinguishability in asphyxial neonates in spite of gestational age or birth weight in the Chinese population. Further studies with large numbers of cases are required to assess whether Cys-C could replace creatinine (Cr) and blood urea nitrogen (BUN) as an endogenous marker of renal function.

Keywords: asphyxia; blood urea nitrogen; creatinine; cystatin C.

MeSH terms

  • Adult
  • Asphyxia Neonatorum / blood
  • Asphyxia Neonatorum / epidemiology
  • Asphyxia Neonatorum / therapy
  • Blood Urea Nitrogen
  • Case-Control Studies
  • China / epidemiology
  • Creatinine / blood
  • Cystatin C / blood*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature / blood
  • Intensive Care, Neonatal
  • Male

Substances

  • Cystatin C
  • Creatinine