Features of lipid, carbohydrate metabolism and renal function in patients with type 1 diabetes and different levels of albumin in the urine depending on the level of cystatin C

Abstract

Annotation. The aim of the study was to examine the differences in lipid, carbohydrate metabolism and renal function in patients with type 1 diabetes (T1D) with different levels of albumin in the urine depending on the level of cystatin C. The sample was 78 men and 62 women aged 22-26 years, T1D patients. The control group consisted of 8 almost healthy men and 13 almost healthy women of the same age. The level of microalbuminuria and cystatin C was determined in all patients by enzyme-linked immunosorbent assay. Biochemical evaluation of fasting glucose, fasting blood glucose, glucose 2 h after exercise, mean value of glucose, glycated hemoglobin, total cholesterol, triglycerides, GFR according to Cockcroft-Gault, CKD EPI and GFR according to cystatin C. Statistical processing of the obtained results was performed in the license package “Statistica 5.5”, using non-parametric evaluation methods. In T1D patients compared to the control group found significantly higher values – fasting blood glucose, glucose 2 hours after exercise, the average value of glucose, glycated hemoglobin, total cholesterol and triglycerides, cystatin C and lower values – international normal ratio, GFR according to Cockcroft-Gault, GFR by CKD EPI and GFR by cystatin C. With increasing levels of albumin in urine in patients with cystatin C<0.9, there were changes in the following indicators: higher values of total cholesterol in men with proteinuria compared to men with normo- and microalbumin ; and lower values – the international normal ratio in women with microalbuminuria, compared with women with normoalbuminuria; Cockcroft-Gault GFR in men with proteinuria and GFR by CKD EPI in men with proteinuria and microalbuminuria compared to men with normoalbuminuria. With increasing levels of albumin in the urine in patients with cystatin C>0.9 there were changes in the level of the following indicators: higher values – fasting blood glucose and triglycerides in women with proteinuria compared with women with normoalbuminuria, and glycated hemoglobin and total cholesterol compared with and microalbuminuria; international normal ratio in men with microalbuminuria, compared with men with normoalbuminuria; and smaller values – GFR level by Cockcroft-Gault in men with microalbuminuria compared to men with normoalbuminuria; GCF levels by Cockcroft-Gault in women with proteinuria compared to women with microalbuminuria and GFR levels by CKD EPI in women with proteinuria compared to women with normoalbuminuria and microalbuminuria. With increasing levels of cystatin C, a decrease in glycated hemoglobin in men and women with microalbuminuria and triglycerides in women with microalbuminuria, as well as greater values of the international normal ratio in men with normoalbuminuria and GFR on cystatin C in men and women with normoalbuminuria and micro. Thus, the study obtained results that indicate the existence of differences in the studied indicators between healthy and sick subjects, between men and women and between groups of T1D patients’ men or women with different levels of albumin and cystatin C.