Cystatin C-estimated GFR correlates with endothelial function improvements following bariatric surgery

IF 4.4 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Clinical Investigation Pub Date : 2025-03-11 DOI:10.1111/eci.70026

Diego Moriconi, Monica Nannipieri, Silvia Armenia, Anna Solini, Rosa Maria Bruno

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Abstract

Background

Obesity is a critical risk factor for chronic kidney disease and cardiovascular disease. The study aimed to explore the relationship between endothelial function, assessed by flow-mediated dilation (FMD), and kidney function, estimated using cystatin C-based eGFR (eGFRcys), in individuals with severe obesity undergoing bariatric surgery.

Methods

Sixty-five individuals with a BMI >35 kg/m² scheduled for bariatric surgery were assessed before and 1 year post-surgery. Vascular health was evaluated using FMD, pulse wave velocity and renal resistive index, while kidney function was measured using creatinine-based (eGFRcr) and cystatin C-based (eGFRcys) equations. FMD was calculated using both traditional and allometric scaling methods to account for variations in brachial arterial diameter.

Results

Bariatric surgery significantly improved BMI, FMD (p < .001) and eGFRcys (p = .042). Before surgery, eGFRcys was positively correlated with FMD (r = .30, p = .011) and inversely correlated with cf-PWV (r = −.26, p = .020), while eGFRcr showed weaker or non-significant associations with vascular variables. eGFRcys increased post-surgery, correlating positively with improvements in FMD (traditional: r = .26, p = .038; allometric: CI [.19, .82], p = .003). Multivariable mixed models confirmed the robust association between eGFRcys and FMD calculated by allometric scaling, independent of BMI or blood pressure changes. In contrast, eGFRcr showed no significant association with FMD changes.

Conclusions

Bariatric surgery enhances both renal and vascular health in individuals with severe obesity. Cystatin C-based eGFR correlates more strongly with endothelial function improvements than creatinine-based eGFR. These findings highlight the utility of cystatin C as an integrative marker for assessing renal and vascular risk in populations affected by obesity undergoing metabolic surgery.

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减肥手术后胱抑素c估计的GFR与内皮功能改善相关。

背景：肥胖是慢性肾脏疾病和心血管疾病的重要危险因素。该研究旨在探讨在接受减肥手术的严重肥胖患者中，通过血流介导扩张（FMD）评估的内皮功能与使用基于胱抑素c的eGFR （eGFRcys）评估的肾功能之间的关系。方法：对65例体重指数bbb35 kg/m2计划进行减肥手术的患者进行术前和术后1年的评估。使用FMD、脉搏波速度和肾阻力指数评估血管健康，使用基于肌酐（eGFRcr）和基于胱抑素c （eGFRcys）的方程测量肾功能。FMD采用传统和异速缩放方法计算，以解释肱动脉直径的变化。结果：减肥手术可显著改善BMI和FMD (p)。结论：减肥手术可改善严重肥胖患者的肾脏和血管健康。以胱抑素c为基础的eGFR与内皮功能改善的相关性比以肌酐为基础的eGFR更强。这些发现强调了胱抑素C作为评估肥胖人群接受代谢手术时肾脏和血管风险的综合标志物的效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Investigation 医学-医学：内科

CiteScore

9.50

自引率

3.60%

发文量

192

审稿时长

1 months

期刊介绍： EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.