Effects of Traumatic Amputation on β-Trace Protein and β2-Microglobulin Concentrations in Male Soldiers

Am J Nephrol. 2015;42(6):436-42. doi: 10.1159/000443775. Epub 2016 Jan 23.

Abstract

Background: Serum creatinine (SCr) levels are decreased following traumatic amputation, leading to the overestimation of glomerular filtration rate (GFR). β-Trace protein (BTP) and β2-microglobulin (B2M) strongly correlate with measured GFR and have not been studied following amputation. We hypothesized that BTP and B2M would be unaffected by traumatic amputation.

Methods: We used the Department of Defense Serum Repository to compare pre- and post-traumatic amputation serum BTP and B2M levels in 33 male soldiers, via the N Latex BTP and B2M nephelometric assays (Siemens Diagnostics, Tarrytown, N.Y., USA). Osterkamp estimation using DEXA scan measurements was used to establish percent estimated body weight loss (%EBWL). Results were analyzed for small (3-5.9% EBWL), medium (6-13.5%), and large (>13.5%) amputation subgroups; and for a control group matched 1:1 to the 12 large amputation subjects. Paired Student's t test was used for comparisons.

Results: Mean serum BTP levels were unchanged in controls, all amputees, and the small and medium amputation subgroups. BTP appeared to decrease following large %EBWL amputation (p = 0.05). Mean serum B2M levels were unchanged in controls, all amputees, and the small and medium amputation subgroups. B2M appeared to increase following large %EBWL amputation (p = 0.05).

Conclusions: BTP and B2M levels are less affected than SCr by amputation, and should be considered for future study of GFR estimation. BTP and B2M changes following large %EBWL amputation require validation and may offer insight into non-GFR BTP and B2M determinants as well as increased cardiovascular disease and mortality following amputation.

MeSH terms

  • Absorptiometry, Photon
  • Adolescent
  • Adult
  • Amputation, Traumatic / blood*
  • Body Weight
  • Brain Injuries
  • Case-Control Studies
  • Creatinine / blood
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Intramolecular Oxidoreductases / blood*
  • Kidney Function Tests
  • Lipocalins / blood*
  • Male
  • Middle Aged
  • Military Personnel*
  • Models, Statistical
  • Nephelometry and Turbidimetry
  • Registries
  • United States
  • Weight Loss
  • Young Adult
  • beta 2-Microglobulin / blood*

Substances

  • Lipocalins
  • beta 2-Microglobulin
  • Creatinine
  • Intramolecular Oxidoreductases
  • prostaglandin R2 D-isomerase