Cystatin C improves cardiovascular risk prediction in cardiometabolic patients in addition to estimated glomerular filtration rate

Background: Cystatin C (Cys C), deemed as a glomerular renal function biomarker with unique properties to be an independent predictor of cardiovascular disease (CVD), remains a matter of investigation among different categories of patients. The aim of the study is a determining the diagnostic and prognostic value of Cys C in the development of cardiovascular complications in patients with arterial hypertension (AH) and different comorbidities, such as type 2 diabetes mellitus (T2DM) and obesity, as a supplement to estimated glomerular filtration rate (eGFR). Material and methods: 111 patients with AH (men/women — 50/61) and 20 control subjects were examined. All patients with AH at the age of 54.37 ± 1.18. During a thorough examination and follow-up of patients, they were classified into 4 groups depending on the comorbidities they had: patients with AH — group 1 (22 people); patients with AH in combination with obesity — group 2 (30 people); AH in combination with T2DM — group 3 (31 people); patients with AH, T2DM — group 4 (28 people). Cys C content and insulin levels in blood serum were measured by enzyme-linked immunosorbent assay on a Labline-90 analyzer (Austria) with commercial test systems manufactured by Elabscience (ELISA, China) and Monobind Inc. (ELISA, USA), according to the instructions included in the kits. Results: It has been proven that an increase in Cys C levels are associated with a decrease in eGFR in comorbid patients with T2DM (r = –0.676; p = 0.038) and without it (r = –0.589; p = 0.016). A significant increase in Cys C levels and cardiovascular accidents in comorbid patients was found. Conclusions: Cys C is a significant marker for predicting cardiovascular risk in comorbid patients with AH.