Assessment of two novel renal tubular proteins in type 2 diabetic patients with nephropathy

Nephropathy is a common health issue associated with type 2 diabetes mellitus (T2DM). Treatment of diabetic nephropathy (DN) in an early stage can effectively inhibit its progression. Albuminuria is the currently accepted marker for detection of DN.This study aims to evaluate the urinary level of tw...

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Bibliographic Details
Published in:Journal of investigative medicine 2020-03, Vol.68 (3), p.748-755
Main Authors: Abdel Ghafar, Muhammad Tarek, Shalaby, Khaled Hamed, Okda, Hanaa Ibrahim, Abo El gheit, Rehab E, Soliman, Nema Ali, Keshk, Walaa Arafa
Format: Article
Language:English
Subjects:
Accuracy
Autoimmune diseases
Automation
Biomarkers
Cell adhesion & migration
Diabetes
Diabetic nephropathy
Disease prevention
Enzymes
Fasting
Hyperglycemia
Immunoassay
Kidney diseases
Laboratories
Urine
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Summary:Nephropathy is a common health issue associated with type 2 diabetes mellitus (T2DM). Treatment of diabetic nephropathy (DN) in an early stage can effectively inhibit its progression. Albuminuria is the currently accepted marker for detection of DN.This study aims to evaluate the urinary level of two novel renal tubular proteins (cyclophilin A and periostin) in patients with T2DM and among different nephropathy stages and also to validate the diagnostic accuracy of both cyclophilin A and periostin as potential markers for early prediction of DN relative to albuminuria.This cross-sectional study recruited 137 patients with T2DM, and they were divided based on their urinary albumin:creatinine ratio into T2DM with normoalbuminuria (group II), incipient T2DN with microalbuminuria (group III) and overt T2DN with macroalbuminuria (group IV) beside 41 healthy subjects as group I. Cyclophilin A and periostin were measured in the urine using ELISA. Diagnostic accuracy of both markers was determined for prediction of DN via receiver operating characteristic curve analyses.Urinary cyclophilin A and periostin levels were significantly higher in DN groups when compared with T2DM with normoalbuminuria group. For prediction of incipient and overt DN, areas under the curve (AUCs) of periostin were 0.954, 0.997 and cyclophilin A were 0.914, 0.937, respectively. AUCs of periostin were higher than that for cyclophilin A with a significant AUC difference (p=0.022) in overt DN stage.Periostin and cyclophilin A could be regarded as a potential urinary biomarker for early prediction of DN. Periostin exhibits a higher diagnostic accuracy than urinary cyclophilin A specifically in overt DN stage.
ISSN:1081-5589
1708-8267
DOI:10.1136/jim-2019-001135