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THE SERUM CREATININE TO CYSTATIN RATIO IN THYROTOXICOSIS PATIENTS: A CASE-CONTROL STUDY.

Y Hu1,2, H Peng3, L Tong1

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The serum creatinine to cystatin C ratio aids in diagnosing thyrotoxicosis and identifying its cause. This ratio is lower in Graves' disease compared to other thyroid conditions.

Keywords:
Graves’ diseaseHashimoto's thyroiditisThyrotoxicosisserum creatinine to cystatin C ratiosubacute thyroiditis

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Area of Science:

  • Endocrinology
  • Clinical Chemistry

Background:

  • Previous research suggests a link between creatinine, cystatin levels, and thyroid disorders.
  • The diagnostic utility of the serum creatinine to cystatin C ratio (Cr:Cyc) in thyrotoxicosis requires further investigation.

Purpose of the Study:

  • To evaluate the diagnostic value of the serum Cr:Cyc ratio for thyrotoxicosis.
  • To explore the Cr:Cyc ratio's role in differentiating the causes of thyrotoxicosis.

Main Methods:

  • A study involving 184 patients with thyrotoxicosis and 406 healthy controls.
  • Assessment of baseline characteristics and serum Cr:Cyc ratios across groups and subgroups.
  • Correlation and Receiver Operating Characteristic (ROC) curve analyses were performed.

Main Results:

  • The Cr:Cyc ratio was significantly lower in Graves' disease (GD) compared to Hashimoto's thyroiditis (HT) and subacute thyroiditis (SAT).
  • In GD, the Cr:Cyc ratio correlated positively with thyroid stimulating hormone (TSH) and thyrotropin receptor antibody (TRAb), and negatively with free triiodothyronine (FT3) and free thyroxine (FT4).
  • ROC analysis showed a high area under the curve (AUC) of 0.933 for diagnosing thyrotoxicosis and 0.778 for diagnosing GD using the Cr:Cyc ratio.

Conclusions:

  • The serum Cr:Cyc ratio demonstrates significant clinical value in diagnosing thyrotoxicosis.
  • This ratio is also useful for identifying the specific etiology of thyrotoxicosis, particularly differentiating Graves' disease.