Abstract
Background: To evaluate the clinical utility of serum cystatin C in estimating glomerular filtration rate (GFR) in cirrhosis patients treated at the Department of Gastroenterology, Da Nang Hospital.
Materials and methods: A cross-sectional analytical study was conducted involving 101 patients with liver cirrhosis and 115 healthy individuals as the control group. Serum levels of creatinine and cystatin C were quantitatively measured; GFR was estimated using the 2021 CKD-EPI equation incorporating both creatinine and cystatin C. Correlations between continuous variables were assessed using Pearson’s correlation coefficient. Diagnostic performance was analyzed via receiver operating characteristic (ROC) curves, with area under the curve (AUC), sensitivity, and specificity reported. Statistical analysis was performed using SPSS software version 22.0.
Results: The mean age of cirrhotic patients was 57.6 ± 11.3 years, with males accounting for 77.2%. The mean serum cystatin C concentration was 1.3 ± 0.5 mg/L. No statistically significant differences in cystatin C levels were observed across age or gender groups. Serum cystatin C showed a strong inverse correlation with estimated GFR based on the CKD-EPI creatinine–cystatin C equation (r = - 0.902; p < 0.001), which was stronger than that of creatinine (r = –0.699; p < 0.001). Among patients with GFR < 60 ml/min/1.73 m², cystatin C demonstrated excellent diagnostic performance, with a cutoff value of > 1.5 mg/L yielding 91.3% sensitivity, 98.7% specificity, and an AUC-ROC of 0.988 (p < 0.001), outperforming creatinine (AUC-ROC = 0.905; sensitivity = 87.0%; specificity = 89.7%; p < 0.001). In the subgroup with GFR 60–89 ml/min/1.73 m², cystatin C also showed superior prognostic value; at the optimal cutoff > 1.02 mg/L, it achieved a sensitivity of 95.6%, specificity of 93.9%, and AUC-ROC of 0.991 (p < 0.001), again surpassing serum creatinine.
Conclusion: Serum cystatin C is a highly valuable biomarker for assessing reduced glomerular filtration rate in patients with liver cirrhosis. It demonstrates superior sensitivity, specificity, and early detection capability for renal dysfunction compared to creatinine.
| Published | 2025-09-30 | |
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| Issue | Vol. 15 No. 5 (2025) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2025.5.11 | |
| Keywords | Cystatin C huyết thanh, mức lọc cầu thận, xơ gan Serum cystatin C, glomerular filtration rate, cirrhosis |
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Copyright (c) 2025 Hue Journal of Medicine and Pharmacy
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