Remodeling of the major arteries of the brain and serum cystatin C levels in patients with non-communicable diseases

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Objective. To evaluate serum cystatin C concentrations and the remodeling of major arteries in patients with non-communicable diseases (NCDs). Material and methods. A total of 460 patients diagnosed with NCDs participated in the study, including 229 (49.8%) males and 231 (50.2%) females, with a mean age of 53.4±14.2 years. The subjects were categorized into three groups (1—3) based on serum cystatin C levels. Multiple laboratory, clinical, and instrumental parameters were assessed. Results. In individuals with NCDs, an increase in serum cystatin C from 1 mg/L to 3 mg/L correlated with an elevation in systolic blood pressure from 128±17 mmHg to 145±24 mmHg, and diastolic blood pressure from 84±10 mmHg to 87±12 mmHg. Additionally, total cholesterol levels rose from 4.68±1.00 mmol/L to 5.24±1.91 mmol/L, low-density lipoproteins increased from 3.15±0.88 mmol/L to 3.31±1.56 mmol/L, and triglycerides increased from 1.13 [0.89; 1.61] mmol/L to 1.59 [1.10; 2.45] mmol/L. Potassium levels increased from 4.35±0.61 mmol/L to 4.81±0.96 mmol/L, and creatinine levels rose from 67.3±13.1 μmol/L to 149.4 [102.8; 291.7] μmol/L. C-reactive protein levels rose from 7.8% to 22.8%, and fibrinogen levels increased from 3.0 [2.6; 3.7] g/L to 4.4 [3.3; 5.7] g/L, while urinary protein excretion increased from 423 [0; 100] mg/L to 6722 [0; 1250] mg/L. The estimated glomerular filtration rate decreased from 101.1±15.9 mL/min/1.73 m2 to 44.0 [22.0; 61.0] mL/min/1.73 m2. The diameter of the ascending aorta also increased, from 2.96±0.36 cm to 3.22±0.31 cm, while the prevalence of aortic atherosclerosis rose from 50.0% to 81.3%. The thickness of the intima-media complex (IMC) of the common carotid artery (CCA) increased from 0.87±0.24 mm to 1.04±0.26 mm, and the diameter of the vertebral arteries expanded from 3.47±0.37 mm to 3.62±0.40 mm. A decline in high-density lipoproteins was observed, from 1.16±0.30 mmol/L to 1.09±0.31 mmol/L, and calcium levels decreased from 2.16±0.33 mmol/L to 2.01±0.37 mmol/L. In groups 2 and 3, localized thickening of the CCA IMC of 1.11—1.3 mm was identified in 39 (19.3%) and 22 (18.6%) subjects, respectively. Local thickening of CCA IMC exceeding 1.3 mm was identified in 35 (17.3%) and 21 (17.8%) patients in groups 2 and 3, respectively. Serum cystatin C levels were significantly correlated with the diameter of the ascending aorta (r=0.307; p<0.05), the diameter of the vertebral arteries (r=0.224; p<0.05), and the thickness of the CCA IMC (r=0.324; p<0.05). Conclusion. Measurement of serum cystatin C in patients with non-communicable diseases demonstrates promising diagnostic utility as a laboratory marker of arterial remodeling and reflects the cerebrovascular risk, correlating with the wall thickness of the major arteries of the brain.

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