LAUSR

Objective: Epidemiological studies show that high circulating cystatin C is associated with risk of cardiovascular disease, independent of creatinine-based renal function measurements. The aim of our study was to evaluate the association between the levels of natriuretic peptides (BNP and NTproBNP) and serum cystatin C in patients with diabetes. Design and method: A total of 449 patients with type 1 and type 2 diabetes, aged 34 to 84 years, were examined. All patients underwent standard clinical and laboratory examination, with an assessment of the levels of BNP and NTproBNP. Renal function was assessed based on the levels of serum creatinine, glomerular filtration rate, which was calculated according to the CKD-EPI formula, and albuminuria, which was assessed as albumin/creatinine ratio (A/C). An echocardiographic examination was conducted according to the standard protocol with the calculation of dimensional, volume and speed characteristics. Results: 57% DM patients had BNP and NTproBNP levels exceeding the diagnostic values of BNP > 35 pg/ml and/or NTproBNP > 125 pg/ml. The levels of BNP and NTproBNP positively correlated with the levels of homocysteine, uric acid, IL-6, C-reactive protein, high-sensitivity C-reactive protein, A/C, creatinine, cystatin C, TNF-alpha, chemokines (MIG, RANTES), growth factors (FGF-23, VEGF-A) (p < 0.05). According to logistic regression analysis, predictor for increased proBNP was cystatin C, rather than creatinine (ß = 7,216, p = 0,042). ROC analysis determined the diagnostic significance of cystatin C for the prediction of increased NTproBNP. Thus, when the level of cystatin C (AUC-0.798) was 0.96 mg/l, the sensitivity and specificity for increased NT-proBNP concentration were 81% and 69%, respectively. Conclusions: Cystatin C might be an independent predictor of increased levels of natriuretic peptide in patients with diabetes.