DIAGNOSTIC AND PROGNOSTIC VALUE OF Β2-MICROGLOBULIN IN THE DEVELOPMENT OF CARDIORENAL SYNDROME IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND ARTERIAL HYPERTENSION

Abstract

Arterial hypertension is the largest pandemic in the history of mankind, which defines the structure of cardiovascular morbidity and mortality. Currently, the correlation between hypertension and various pathological conditions and diseases has been proven, which largely determines its progression and contributes to the development of cardiovascular and renal complications. These diseases include type 2 diabetes mellitus, which is spreading globally as a pandemic. The history of arterial hypertension in combination with type 2 diabetes mellitus is often accompanied by the development of cardiorenal syndrome, so it is crucial to diagnose renal dysfunction and prevent cardiovascular complications in such patients. One of these biomarkers is β2-microglobulin (β2-M), which depends on the glomerular filtration rate and tubular reabsorption.

Materials and methods. 90 patients with AH (men/women – 48/42) and 20 control subjects were examined. During a thorough examination and follow-up of patients, they were classified into 3 groups: patients with AH – group 1 – 31 people; group 2 – AH in combination with T2DM – 31 people; group 3 – patients with AH, T2DM, and obesity – 28 people. Body weight and height were measured in all patients, and BMI = body weight/height² (m²) was calculated. The β2-microglobulin levels in the patients' serum, cardiotrophin-1, catestatin, leptin, cystatin C, neutrophil gelatinase-associated lipocalin, and N-terminal pro-brain natriuretic peptide, 25-OH total vitamin D, serum insulin levels, glycosylated hemoglobin, lipid metabolism, and systolic and diastolic blood pressure were measured. Statistical data analysis was performed using Statistica, 12 (Stat Soft Inc, USA) and Microsoft Office Excel 2013. The data are presented as mean (M) and standard deviation (δ). Differences between groups of mean values were evaluated using the Student's t-test.

Results and conclusions. The level of β2-M in the observed groups of patients differed significantly from that of healthy individuals. An increase in β2-M concentration allowed us to confirm the presence of tubular renal dysfunction, which was not diagnosed by conventional methods. All examined patients were divided into 2 groups depending on the β2-M level. Our data prove the role of β2-microglobulin as an independent biomarker of renal dysfunction, as well as the development of early cardiovascular complications. The data obtained from the mathematical models between creatinine and β2-microglobulin, urea and β2-microglobulin levels show a highly significant correlation between β2-microglobulin and renal function and demonstrate that β2-microglobulin is an independent factor in the prediction of renal dysfunction in patients with hypertension and concomitant type 2 diabetes mellitus. β2-microglobulin is a biomarker that should be used in the diagnosis and prognosis of early manifestations of cardiorenal syndrome.