Higher Levels of Cystatin C in HIV/AIDS Patients with Metabolic Syndrome

Abstract

Data about Cystatin-C levels in HIV-infected patients with metabolic syndrome (MetS) are still limited. Therefore, the aim of this study was to evaluate the possible correlations of serum levels of Cystatin-C in HIV/AIDS patients treated with combined antiretroviral therapy (cART) with or without MetS. This cross-sectional study included 89 HIV/AIDS Caucasian patients receiving cART at the HIV/AIDS Centre Belgrade, Serbia, divided into two groups according to the presence of MetS. Cystatin-C and other biochemical parameters were measured using Cytokine-Array-I, Metabolic-Array-I and Metabolic-Array-II, at the Department of Clinical Biochemistry, Royal Free Hospital and University College London, UK. A linear regression model was performed to evaluate which clinical and laboratory variables had an independent effect on Cystatin-C levels in HIV/AIDS patients. There were 33 (37%) patients with MetS and 56 (63%) without MetS. Patients with and without MetS were homogenous for age, duration of cART, number of cART combinations and CD4 T cell count. Statistically increased Cystatin-C levels were observed in HIV/AIDS patients with MetS (p = 0.017), when compared to patients without MetS. Data showed a positive correlation of Cystatin-C and C-reactive protein (r = 0.349, p = 0.001). Using linear regression modelling, significant correlations were obtained between Cystatin-C and MetS in univariate analysis (p < 0.001). Cystatin-C levels were significantly higher in HIV/AIDS patients with MetS versus without MetS. Early assessment of MetS using Cystatin-C as a marker may ultimately help increase the lifespan of HIV/AIDS patients, as these patients appear to be at high risk of cardiovascular diseases.

Immune Activation, Inflammation, and Non-AIDS Co-Morbidities in HIV-Infected Patients under Long-Term ART

“…The combination of HIV infection with MetS seems to exacerbate the renal damage caused by the virus, with PLWH presenting a higher urinary albumin–creatinine ratio compared to non-HIV-infected patients with MetS [99]. Always related to renal damage, a correlation was found between levels of cystatin-C (a marker of kidney function recently shown to be associated with a risk of developing CVDs and DM) and MetS [100]. PLWH with MetS showed higher levels of aspartate transaminase, triglycerides, and blood pressure, and lower levels of cholesterol HDL compared to patients without MetS.…”

Evaluation of microalbumin, cystatin c, creatinine and uric acid levels in HIV patients in Nnamdi Azikiwe University Teaching Hospital, Nnewi

“…Several studies have shown elevated levels of cystatin C in HIV positive patients in recent times which confirm the current result. 19,20 In this study, there was no significant difference in the mean plasma uric acid level observed in the symptomatic HIV participants on long term ART when compared to symptomatic HIV participants on short term ART (p>0.05). This may mean that duration of ART does not affect uric acid level in HIV participants.…”

“…24 However, the present result is in contrast with the results of some other similar studies documenting significantly elevated creatinine levels in HIV participants and HIV participants on ART compared to control group. 11,[13][14][15][16][17][18][19][20][21][22][23][24][25] Creatinine is a non-protein nitrogenous compound that is produced by the breakdown of creatine in muscle. Creatinine is found in serum, plasma, and urine and is excreted glomerular filtration at a constant rate and in the same concentration as in plasma.…”

“…17 Some studies indicate that the changes in cystatin C levels may contribute in the detection of renal failure 18,19 andseveral studies have shown elevated levels of cystatin C in HIV positive patients in recent times. 20,21 Creatinine is freely excreted through kidneys which makes it useful to interpret kidney function and elevated levels of creatinine have been seen in HIV positive persons 11,[13][14][15][16][17][18][19][20][21][22][23] although some others recorded no significant alterations. 24,25 Elevated serum uric acid levels are associated with endothelial dysfunction in HIV patients.…”

Association of cystatin C levels with metabolic syndrome incidence: a nested case-control study with propensity score matching

“…Cystatin C (Cys-C), a low–molecular-weight cysteine protease inhibitor involved in vascular extracellular matrix remodeling, 8 is an established biomarker of glomerular filtration 9 and early renal dysfunction 10 and is also a predictive marker of CVD. 11,12 In the present study, we sought to examine the association between MetS and the biochemical profiles of an adult Chinese cohort.…”