Comparison of serum concentrations of β-trace protein, β2-microglobulin, Cystatin C, and Creatinine in the US population

Stephen P. Juraschek, Josef Coresh, Lesley A. Inker, Andrew S. Levey, Anna Köttgen, Meredith C. Foster, Brad C. Astor, John H. Eckfeldt, Elizabeth Selvin

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


Background and objectives β-trace protein (βTP), β2-microglobulin (β2M), and cystatin C (CysC) have advantages over creatinine for estimating GFR and prognosis. This study compares the distribution of all fourmarkers in the general population and their associations with possible determinants of GFR. Design, setting, participants, & measurements βTP and β2M were measured in 7596 participants (aged≥12 years) of the Third National Health and Nutrition Examination Survey (1988-1994). βTP and β2M concentrations and the proportion of persons with elevated (≥99th percentile for young healthy participants) βTP (≥0.81 mg/L), β2M (≥2.80 mg/L), standardized CysC (≥1.03 mg/L), and creatinine (≥1.2 mg/dl for men and ≥1.0 mg/dl for women) were compared across demographic and clinical factors. Results Elevated βTP, β2M, and CysC showed stronger associationswith age than elevated serum creatinine, the prevalence of elevated levels reaching 47%, 44%, 58%, and 26%, respectively, by age 80 years. βTP, CysC, and creatinine were higher in men but β2M was not associated with sex. Mexican Americans had lower βTP, β2M, CysC, and creatinine compared with non-Hispanic whites. Hypertension and higher C-reactive protein were associated with elevations in allmarkers, whereas non-Hispanic black race, body mass index, diabetes, smoking status, triglycerides, HDL cholesterol, and education were not associated in a consistent manner across the different markers. Conclusions βTP, β2M, CysC, and creatinine differ in their associations with demographic and clinical factors, suggesting variation in their non-GFR determinants. Future studies should examine these markers with measured GFR to determine their diagnostic and prognostic utility.

Original languageEnglish (US)
Pages (from-to)584-592
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Issue number4
StatePublished - Apr 5 2013


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