Features of the frequency of angio-, retino- and neuropathy, general clinical and anthropometric parameters in patients with type 1 diabetes with different levels of albumin in the urine depending on the level of cystatin C
Cystatin C improves the risk stratification among people with diabetic nephropathy, the risk of mortality, cardiovascular disease, disorders of the visual organ and nervous system in the preclinical and early stages. The aim of the study was to study the frequency of angio-, retino- and neuropathy, as well as differences in general clinical and anthropometric parameters in patients with type 1 diabetes (T1D) with different levels of albumin in the urine depending on cystatin C. The sample was 78 men and 62 women aged 22-26 years, patients with T1D, who were hospitalized in the therapeutic department №1 and №2 of the Vinnytsia Regional Highly Specialized Endocrinology Center. The control group consisted of 8 healthy men and 13 healthy women of the same age. The level of microalbuminuria and cystatin C was determined for all patients by enzyme-linked immunosorbent assay. The frequency of angio-, retino- and neuropathy, general clinical (systolic, diastolic, pulse) and anthropometric (height, weight, body surface area, waist circumference, body mass index) was assessed indicators. Statistical processing of the obtained results was performed in the license package “Statistica 5.5”, using non-parametric evaluation methods. It was found that in the group of men with cystatin C<0.9, and in women with cystatin C>0.9 with increasing albuminuria, the percentage of patients with more severe microvascular complications of T1D. In patients with diabetes mellitus 1 compared with the control group systolic blood pressure is significantly higher and increases with increasing albumin levels in the urine (with cystatin C<0.9 – in men with normo-, microalbuminuria and proteinuria by 7.14%, 8.1% and 10.8%; in women with normo-, microalbuminuria by 7.5% and 10.0%, with cystatin C>0.9 – in men with normo-, microalbuminuria by 4.9% and 7.2%, in women with proteinuria by 19.5%). Similar changes were found for diastolic blood pressure (with cystatin C<0.9 – in men with proteinuria by 13.0%; in women with normo-, microalbuminuria by 11.4% and 13.4%; with cystatin C>0.9 – in men with microalbuminuria by 9.0%; in women with normo- and proteinuria by 9.5% and 21.5%) and heart rate (with cystatin C<0.9 – in men with microalbuminuria and proteinuria by 18.4% and 12.6%, in women with microalbuminuria by 9.13%; with cystatin C>0.9 – in men with microalbuminuria by 12.0%, in women with normo-, microalbuminuria and proteinuria by 10.1%, 16.3% and 25.3%). In patients with T1D compared to the control group, the length of the body is significantly smaller and decreases with increasing levels of albumin in the urine (with cystatin C<0.9 – in men with normo-, microalbuminuria and proteinuria by 3.6%, 6.7% and 9.0%; women with microalbuminuria by 1.9%, with cystatin C>0.9 – in men with normo-, microalbuminuria by 5.2% and 7.3%, in women with normoalbuminuria and proteinuria by 2.6% and 4.3%). Similar changes were found in men for body weight (with cystatin C<0.9 – with microalbuminuria and proteinuria by 13.6% and 30.1%; with cystatin C>0.9 – with normo- and microalbuminuria by 10.2% and 25.4%) and body surface area (with cystatin C<0.9 – with normo-, microalbuminuria and proteinuria by 5.8%, 10.8% and 18.9%; with cystatin C>0.9 – with normo- and microalbuminuria by 8.2% and 16.2%). The size of the waist circumference in patients with T1D with normoalbuminuria is significantly higher, and in patients of other groups significantly less than in healthy subjects (with cystatin C<0.9 – with normo-, microalbuminuria and proteinuria by 3.8%, 1.2% and 5.2%; cystatin C>0.9 – with microalbuminuria by 5.1%). Compared to healthy women, the waist circumference was significantly higher in sick women (with cystatin C<0.9 – with normo- and microalbuminuria by 11.2% and 10.7%; with cystatin C>0.9 – with normo- and proteinuria by 9.7% and 6.0%). In patients with T1D men with proteinuria compared with the control group, the value of the body mass index was significantly lower by 9.7% (cystatin C<0.9). The value of the body mass index was significantly higher in patients with normoalbuminuria and microalbuminuria – by 11.8% and 17.7% (cystatin C<0.9), respectively, and in patients with proteinuria by 7.2% (cystatin C>0.9) compared with healthy women. Thus, between healthy and patients with T1D with varying degrees of albuminuria, differences in general clinical and anthropometric parameters were found, and they are greater the higher the level of cystatin C.
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