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  • Title: [Cystatin C and preclinical lesions in the target organs of hypertensive patients].
    Author: Oshchepkova EV, Dmitriev VA, Titov VN.
    Journal: Ter Arkh; 2014; 86(9):31-7. PubMed ID: 25518503.
    Abstract:
    AIM: To study the association between cystatin C levels and preclinical lesions in the target organs (heart, kidney, vessels) of patients with hypertensive disease (HD) at moderate and high risks for cardiovascular events (CVE). SUBJECTS AND METHODS: The investigation enrolled 47 patents (30 men and 17 women) with Stages I-II HD at moderate (n = 23) and high (n = 24) risks for CVE. The patients' mean age was 46.0 ± 1.8 years; the duration of HD was 4.1 ± 0.2 years. The blood level of cystatin C was estimated by photometry using a biochemical autoanalyzer. Glomerular filtration rate (GFR) was calculated by the MDRD formula. Microalbuminuria (MAU) was determined by turbidimetry employing a biochemical autoanalyzer. RESULTS: No association between cystatin C level and 24-hour blood pressure (BP) monitoring readings was found in the patients except the men in whom it was correlated with 24-hour diastolic BP (DBP) (r = 0.36; p < 0.05). The hypertensive patients showed a positive correlation of cystatin C with their age (r = 0.51; p < 0.001). There were higher cystatin C levels in smoking patients with HD (n = 19) and no statistically significant differences in the level of MAU, urine uric acid, and GFR between them. There was a statistically highly significant negative. correlation between cystatin C concentration and GFR by the MDRD formula (r = -0.59; p < 0.001), at the same time, no correlation was found between creatinine clearance (by the Cockroft-Gault formula). There were no statistically significant differences in cystatin C levels in relation to the presence or absence of carotid atherosclerosis (1.01 ± 0.03 and 0.93 ± 0.02 mg/l, respectively; p = 0.08). Overall, there was a positive correlation of cystatin C levels with left ventricular mass index (r = 0.58; p < 0.001) and relative myocardial thickness index (r = 0.40; p < 0.05). CONCLUSION: The findings of the association of cystatin C and 24-hour DBP, preclinical lesions in the heart, vessels, and kidney seem to argue for the concept of cardiorenal syndrome in patients with HD just at its early stages.
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