CYSTATIN C AND LIPOCALIN-2 AS BIOMARKERS OF INITIAL RENAL DYSFUNCTION WITHIN THE RENAL-METABOLIC CONTINUUM
DOI:
https://doi.org/10.32782/2226-2008-2024-6-5Keywords:
chronic kidney disease, obesity, lipocalin-2, cystatin С, insulin resistanceAbstract
The relevance of the problem of kidney damage in patients with obesity is due to the increase in the frequency of nephropathies associated with metabolic disorders. The aim of the study is to evaluate changes in lipocalin-2 in urine as an early biomarker of renal dysfunction against the background of obesity and its relationship with cystatin C and the HOMA-IR index in such patients. Materials and methods. 300 patients with chronic kidney disease were examined. The patients were divided into 4 groups: group 1 (70) – patients with stage 1 CKD and normal body weight, group 2 (72) – patients with stage 2 CKD and normal body weight; group 3 (70) – patients with 1 stage CKD and obesity, group 4 (88) – patients with stage 4 CKD and obesity. The control group consisted of 30 apparently healthy individuals. BMI was determined for all patients, glomerular filtration rate (GFR) was calculated according to CRD-EPI formulas based on the level of creatinine, cystatin C and their combination (CRD-EPIcysC/cr) (ml/min/1.73 m2). The level of cystatin C in blood serum and lipocalin in urine was determined by enzyme immunoassay methods. The HOMA-IR index was determined by the immunochemiluminescence method and calculated according to the formula. Establishment of the level of glycosylated haemoglobin (HbA1c) was carried out by the spectrophotometric method. Results. In groups of patients with CKD and obesity, the level of lipocalin in urine and cystatin C in blood serum was correlated with indicators of microalbuminuria, BMI, GFR and HOMA-IR. In groups 3 and 4, a negative average correlation between HOMA-IR and CKD (CKD-EPIcysC/cr) was established. Conclusion. The conducted researches indicate an increase in the secretion of lipocalin-2 with urine, especially in people with CKD and a higher body mass index. It can be a significant predictor of albuminuria and is positively correlated with the level of cystatin C and HOMA-IR index. Rates of insulin resistance increased with progression of renal damage.
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