DIAGNOSTIC VALUE OF СYSTATIN C AND COLLAGEN TYPE IV IN PATIENTS WITH HYPERTENSION AND OBESITY

Objective. To study the role of cystatin C and collagen type IV as early diagnostic markers of chronic kidney disease in patients with arterial hypertension (HTN) and obesity. Design and methods. We included 170 people aged 25–55 years old: 90 patients with obesity, metabolic disorders and HTN (“the group of complicated obesity”), 50 — with obesity without metabolic disturbances (“metabolically healthy obesity”), and 30 hypertensive subjects without obesity. Control group consisted of 50 healthy individuals without obesity. We assessed clinical and biochemical indicators, leptin levels, resistin, adiponektin, cystatin C in blood and urine, albuminuria, and collagen IV. Results. In groups of hypertensive patients we found associations between cystatin C level with triglycerides, blood pressure (BP), leptin, resistin, insulin resistance index and albuminuria. Glomerular filtration rate calculated by Hoek’s formula showed decreased kidney function while eGFR by CKD-EPI formula was optimal. Serum cystatin C level correlated with degree of obesity, while urinary excretion of cystatin C showed no association. Patients with «metabolically healthy obesity» showed increased urinary excretion of cystatin C while GFR and albuminuria were within normal values. Hypertensive patients demonstrated higher urinary excretion of collagen type IV and its association with albuminuria, BP level and cholesterol level. Conclusions. In HTN, serum cystatin C concentration is associated with adipokyne levels that confirms the role of hormonal activity of adipose tissue in the development of glomerular and tubular kidney dysfunction. Increased urinary excretion of collagen type IV in hypertensive patients indicates nephrosclerosis, which is augmented in obesity.

arterial hypertension, obesity, adipokines, cystatin C, kidneys

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