Evaluation of Serum Cystatin C Levels in Fibroid Patients in Elele

This study was aimed at determining the serum levels of Cystatin C in fibroid patients. A total of 140 women were recruited for the study, 70 served as control while 70 were fibroid patients (test). Nephelometric Immunoassay Method in Mispa autoanlyser was used for the assay. The data were analyzed with statistical package for social science (SPSS) version 20. The results showed significant difference (P<0.05) when Cystatin C in fibroid subjects (2.6 ± 1.11 mg/dl) were compared to control (1.0 ± 0.34 mg/dl) and there was significant difference (P<0.05) when Cystatin C levels were compared among the different age groups. It was concluded that Cystatin C was elevated in fibroid women.


Introduction
Fibroids are noncancerous growths of the smooth muscle layer of the uterus. Fibroids can range in number and size from a single growth to multiple growths [1,2]. The prevalence of fibroid varies between 5-65% depending on age, ethnicity, geographical region and quality of imaging techniques [3][4][5]. Some fibroids may interfere with pregnancy although this appears to be uncommon [6]. Both genetic factors such as mutations and environmental factors such as obesity have been implicated in the development of fibroids [6].

Study area
The research was carried out on samples from women with fibroid attending Madonna University Teaching Hospital (MUTH) Elele, Rivers State, Nigeria.

Study population
A total of 140 women were enrolled for the study, 70 were fibroid patients (test) and 70 were apparently healthy women (control) attending Madonna University Teaching Hospital (MUTH) Elele.

Ethical clearance
Ethical clearance was obtained from the ethics Committee of Madonna University Elele, through the Head of Departemnt, Medical Laboratory Science which was approved by the management of Madonna University Teaching Hospital Elele.

Informed consent
Informed consent was obtained from the subjects before sample collection.

Sample collection
A 3 ml of venous blood sample was collected from the subjects into plain tubes, allowed to clot and retract and the serum separated for the Cystatin C assay.

Determination of Cystatin C by nephelometric immunoassay method Procedure
The assay was done with auto analyzer. The smart card was inserted, 100 μl of R1 and 10 μl of sample added into the cuvette placed in cuvette holder, mixed automatically for 10 seconds and incubated for 30 seconds. After, 140 μl of R2 was added into the cuvette and mixed for 10 seconds and then the result was displayed and read.

Statistical analysis
Data obtained from these studies were analysed using the statistical package of social science (SPSS) version 20. The results were expressed as mean ± standard deviation (SD). Independent sample t-test was used to compare means and values considered significance at P<0.05. Analysis of variance (ANOVA) was used to compare means of the age groups.

Discussion
Cystatin C is a protein encoded by the CST3 gene. It is a known biomarker of kidney function. Cystatin C is found in virtually all tissues and body fluids. The mean value of serum cystain C in fibroid subjects (2.6 ± 1.11 mg/dl) showed significant increase (P<0.05) compared to control (1.0 ± 0.34 mg/dl). This can be due to the increase in cellular activity in the fibroid growth. According to Akbari [7], increased Cystatin C in late pregnancy and preeclampsia has been explained by changes in renal handling of the protein. There may be increased synthesis of Cystatin C in fibroid patients [8,9]. The results of the different age groups of fibroid and control subjects showed significant difference (P<0.05) when compared based on the age groups of the fibroid subjects. This shows that the age of the women is highly associated with the changes in the level of Cyctatin C in the subjects [10].

Conclusion
It can be concluded that the serum levels of Cystatin C is elevated in fibroid which could be due to increased cellular activity in the fibroid growth. This could be of diagnostic value in fibroid and in the management of the patients. It is crucial to monitor Cystatin C to find out the level of renal derangement in fibroid patients.