Interrelationship of factors associated with the level of neutrophil gelatinase-associated lipocalin in patients with arterial hypertension with and without type 2 diabetes

Abstract

Introduction. Arterial hypertension combined with type 2 diabetes mellitus is
associated with a high risk of cardiovascular and renal complications, highlighting the need
for sensitive biomarkers of early target organ damage.
The aim of the study. To identify clinical and laboratory determinants associated with
neutrophil gelatinase-associated lipocalin (NGAL) levels in patients with arterial hypertension
depending on the presence of type 2 diabetes mellitus.
Materials and Methods. The study included 136 patients with arterial hypertension, divided
into groups with isolated hypertension and hypertension combined with type 2 diabetes.
Comprehensive clinical, laboratory, immunological, and echocardiographic assessments
were performed. Multivariate regression analysis was used to determine independent factors
associated with NGAL levels.
Results. Stratification by the median NGAL level revealed no significant differences in most
clinical and hemodynamic parameters; however, higher NGAL levels were associated with
increased leptin concentrations and lower insulin levels. In patients with isolated hypertension,
NGAL was independently associated with HbA1c and blood urea levels, whereas in patients
with hypertension and type 2 diabetes additional associations with immune and lipid
parameters were observed.
Conclusions. NGAL levels are influenced by a combination of metabolic, immune, and
vascular factors and may serve as an integrated biomarker of early subclinical changes
and cardiometabolic risk in patients with arterial hypertension, particularly in those with
concomitant type 2 diabetes mellitus