Cystatin C an early marker of Glomerular dysfunction in thalassemia major.

  • Sumera Saghir Avicenna Medical College Lahore, Pakistan.
  • Adnan Riaz Islam medical and dental College Sialkot.
  • Aisha Hasan Avicenna Medical College Lahore, Pakistan.
  • Yasir Ali Bhatti Avicenna Medical College, Lahore.
  • Ahmed Ashar Ghuman Islam Medical and Dental College Sialkot.
  • Muhammad Shakil Services Institute of Medical Sciences (SIMS) Lahore.
Keywords: Cystatin C, EGFR, Transfusion Dependent Thalassemia Major Children Ferritin Creatinine

Abstract

Objectives: The objective of the present study is to investigate the role of cystatin C as an early marker of glomerular dysfunction in thalassemia major. Study Design: Cross sectional comparative study. Setting: Department of Biochemistry Post Graduate Medical institute with the Thalassemia Center in Sir Ganga Ram Hospital Lahore. Period: July 2017 and July 2018. Material & Methods: This study examined 90 male children all between the ages of 5-11, using non probability sampling techniques. The children were grouped as 21 healthy male children as control group I and 69 diagnosed male thalassemia major children further subdivided on the basis of serum ferritin level as group II, serum ferritin level <2500ng/ml, group III, serum ferritin level 2500-5000ng/ml and group IV serum ferritin level >5000ng/ml respectively. Individuals with hereditary renal diseases, on steroid therapy, or other co-morbid renal diseases were excluded from the study. Complete blood analysis, serum ferritin, creatinine and cystatin C were measured by Micro lab 300 and solid phase enzyme linked immune sorbent assay (ELISA) respectively. The results were compared by using SPSS version 20. Results: Group I: n=21 healthy children with ferritin between normal range 105.33 ± 30.03, serum creatinine 0.41 ± 0.05, serum cystatin C 0.57 ± 0.14. eGFR-creatinine 133.38±7.63, eGFR-cystatin C 122.9±17.63. Group II: n=20 (β-TM with ferritin <2500ng/ml). Mean ferritin was 1997.5±300.68 ng/ml (P<0.001), creatinine was 0.43± 0.05, serum cystatin C 0.66 ± 0.05 (P<0.05). eGFR-creatinine 121.45±4.89 P<0.05, eGFR-cystatin C 105.15±6.49 P<0.001. Group III: n= 25 (β-TM with ferritin 2500-5000 ng/ml). Mean ferritin level was 3850.0± 718.18 ng /ml (P<0.001), creatinine was 0.5±.07, cystatin C 0.96±0.13 (P<0.001). eGFR-creatinine 103.29±8.26(P<0.001), eGFR-cystatin C 75.75±10.67 (P<0.001). Group IV: n=24 (β-TM with ferritin >5000 ng/ml). Mean ferritin level was 6311.67±1060.61 ng/ml P value (P<0.001), creatinine was 0.57 ± 0.07, cystatin C 1.11 ± 0.09 (P<0.001). eGFR-creatinine 94.42±8.69 (P<0.001), eGFR cystatin C 64.67±4.23(P<0.001). Conclusion: A highly significant positive relation was found between serum ferritin-cystatin C as compared to creatinine among the study groups II, III and IV and significant inverse relationship between cystatin C and eGFR that concluded cystatin C as an early marker of glomerular dysfunction than creatinine in thalassaemia major children.

Author Biographies

Sumera Saghir, Avicenna Medical College Lahore, Pakistan.
  1. Phil

Senior Lecturer Biochemistry

 

Adnan Riaz, Islam medical and dental College Sialkot.
  1. Phil

Assistant Professor Biochemistry

 

Aisha Hasan, Avicenna Medical College Lahore, Pakistan.

M.Phil

Assistant Professor Biochemistry,

 

Yasir Ali Bhatti, Avicenna Medical College, Lahore.

M.Phil

Assistant Professor Biochemistry 

 

Ahmed Ashar Ghuman, Islam Medical and Dental College Sialkot.

M.Phil

Assistant Professor Biochemistry

Muhammad Shakil, Services Institute of Medical Sciences (SIMS) Lahore.
  1. Phil

Assistant Professor Biochemistry

 

Published
2020-02-10