Factors other than the glomerular filtration rate that determine the serum beta-2-microglobulin level. Is there an association with nutritional status and other parameters?

16.03.2013 / Stanga Z, Nock S, Medina Escobar P, Nydegger UE, Risch M, Risch L
Factors other than the glomerular filtration rate that determine the serum beta-2-microglobulin level. Is there an association with nutritional status and other parameters?

Kurzbeschrieb für Probanden

Es gibt mehrere wertvolle Marker, die Nierenfunktion zu beschreiben. Einer dieser Marker ist das Beta-2-Mikroglobulin. Leider sind die verschiedenen, in der klinischen Routine gebrauchten Marker nicht nur von der Nierenfunktion, sondern auch von anderen Faktoren abhängig. Beim Beta-2-Mikroglobulin sind diese nur schlecht untersucht. Die vorliegende Arbeit ist die erste, welche diese Faktoren eingehende und umfassend untersucht. Es konnte gezeigt werden, dass neben der Nierenfunktion verschiedene Faktoren die Beta-2-Mikroglobulinkonzentration beeinflussen können. Es ist deshalb fraglich, in wieweit Beta-2-Mikroglobulin ein wertvoller Parameter der Nierenfunktion darstellt. Die Resultate dieser Analyse wurden am internationalen IFCC-Euromedlab Kongress für Labormedizin, welcher vom 19. – 23. Mai 2013 in Milano stattgefunden hat, vorgestellt. In der Folge ist daraus die Originalarbeit 3 entstanden.

Kurzbeschrieb für Fachpersonen

Background:

Beta-2-microglobulin is increasingly investigated as a diagnostic marker of kidney function and a prognostic marker of adverse outcomes. To date, non-renal determinants of beta-2-microglobulin levels, including nutritional status, have not been well described.

Methods:

This cross-sectional analysis was performed within the framework of the www.seniorlabor.ch study, which includes subjectively healthy individuals aged >60 years. Nutritional status (assessed with geriatric nutritional risk index, GNRI) and other factors known to have a non-renal influence on kidney function markers were investigated for a non-renal association with serum-beta-2-microglobulin. As a marker of kidney function, cystatin C based estimated glomerular filtration rate (eGFR) was employed.

Results:

A total of 1250 participants (690 females and 590 males) were enrolled in the study. The use of a multivariate regression model revealed that beta-2-microglobulin levels, unlike creatinine levels, did not show a significant association with the GNRI. Nevertheless, beta-2-microglobulin levels were significantly associated with body weight, gender, TSH, CRP and systolic blood pressure independent of the eGFR.

Conclusions:

Although not associated with nutritional status, serum-beta-2-microglobulin levels are related to several other non-renal factors, similar to those known to be related to the levels of cystatin C and creatinine. This result suggests that the beta-2-microglobulin level will not be able to serve as a valuable, alternative parameter to the levels of creatinine and cystatin C when estimating the GFR in routine clinical practice.