Optimized multiparametric approach for early detection of kidney disease in diabetic patients

IF 0.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

International Journal of Diabetes in Developing Countries Pub Date : 2024-09-05 DOI:10.1007/s13410-024-01394-6

Carina P. A. Alofa, Patrice H. Avogbe, Espérance F. E. Kougnimon, Marcos A. D. F. Migan, Riel A. N. Amoussou, Antoine Fandohan, Julien A. G. Segbo, Casimir D. Akpovi

{"title":"Optimized multiparametric approach for early detection of kidney disease in diabetic patients","authors":"Carina P. A. Alofa, Patrice H. Avogbe, Espérance F. E. Kougnimon, Marcos A. D. F. Migan, Riel A. N. Amoussou, Antoine Fandohan, Julien A. G. Segbo, Casimir D. Akpovi","doi":"10.1007/s13410-024-01394-6","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Diabetic Kidney Disease (DKD) is a serious complication of diabetes. Identifying high-risk DKD patients can lead to better clinical outcomes.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>This study aimed to investigate the relevance of three potential predictive markers for DKD: Kidney Injury Molecule-1 (KIM-1), Tumor Necrosis Factor Receptor 1 (TNFR1), and urinary albumin-to-creatinine ratio (ACR).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We recruited 120 participants, including 30 individuals with type 2 diabetes (T2D) but no renal complications, 30 with DKD, and 60 healthy controls. Blood and urine analyses were performed to assess lipid and liver parameters, ACR, and estimated glomerular filtration rate (eGFR). Plasma levels of KIM-1 and TNFR1 were measured using the sandwich ELISA method.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The results demonstrated that KIM-1 (<i>p</i> = 0.008) and TNFR1 (<i>p </i>= 0.006) levels were significantly higher in individuals with T2D compared to the controls and even more elevated in those with DKD (<i>p</i> = 0.003 and <i>p</i> = 0.000, respectively). KIM-1 (<i>p</i> = 0.000) and TNFR1 (<i>p</i> = 0.001) levels were significantly elevated in individuals with T2D without elevated albuminuria compared to control. KIM-1 and TNFR1 exhibited correlations with ACR (r = 0.400; <i>p</i> = 0.002 and r = 0.607; <i>p</i> = 0.000, respectively) and eGFR (r = -0.425; <i>p</i> = 0.001 and r = -0.661; <i>p</i> = 0.000, respectively). The ROC curve analysis revealed an area under the curve (AUC) of 0.91 for TNFR1, 0.76 for KIM-1, and 0.95 for ACR. However, the ACR, KIM-1, and TNFR1 combination showed the best predictive performance with an AUC of 0.98.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Plasma levels of KIM-1 and TNFR1 are promising biomarkers for predicting kidney disease in individuals with diabetes, and their combination with ACR improves the overall diagnostic accuracy.</p>","PeriodicalId":50328,"journal":{"name":"International Journal of Diabetes in Developing Countries","volume":"2 1","pages":""},"PeriodicalIF":0.7000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Diabetes in Developing Countries","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13410-024-01394-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Diabetic Kidney Disease (DKD) is a serious complication of diabetes. Identifying high-risk DKD patients can lead to better clinical outcomes.

Objective

This study aimed to investigate the relevance of three potential predictive markers for DKD: Kidney Injury Molecule-1 (KIM-1), Tumor Necrosis Factor Receptor 1 (TNFR1), and urinary albumin-to-creatinine ratio (ACR).

Methods

We recruited 120 participants, including 30 individuals with type 2 diabetes (T2D) but no renal complications, 30 with DKD, and 60 healthy controls. Blood and urine analyses were performed to assess lipid and liver parameters, ACR, and estimated glomerular filtration rate (eGFR). Plasma levels of KIM-1 and TNFR1 were measured using the sandwich ELISA method.

Results

The results demonstrated that KIM-1 (p = 0.008) and TNFR1 (p = 0.006) levels were significantly higher in individuals with T2D compared to the controls and even more elevated in those with DKD (p = 0.003 and p = 0.000, respectively). KIM-1 (p = 0.000) and TNFR1 (p = 0.001) levels were significantly elevated in individuals with T2D without elevated albuminuria compared to control. KIM-1 and TNFR1 exhibited correlations with ACR (r = 0.400; p = 0.002 and r = 0.607; p = 0.000, respectively) and eGFR (r = -0.425; p = 0.001 and r = -0.661; p = 0.000, respectively). The ROC curve analysis revealed an area under the curve (AUC) of 0.91 for TNFR1, 0.76 for KIM-1, and 0.95 for ACR. However, the ACR, KIM-1, and TNFR1 combination showed the best predictive performance with an AUC of 0.98.

Conclusion

Plasma levels of KIM-1 and TNFR1 are promising biomarkers for predicting kidney disease in individuals with diabetes, and their combination with ACR improves the overall diagnostic accuracy.

Abstract Image

查看原文本刊更多论文

用于早期检测糖尿病患者肾脏疾病的优化多参数方法

背景糖尿病肾病（DKD）是糖尿病的一种严重并发症。本研究旨在探讨肾损伤分子-1（KIM-1）、肿瘤坏死因子受体1（TNFR1）和尿白蛋白与肌酐比值（ACR）这三种潜在的 DKD 预测标志物的相关性。方法我们招募了 120 名参与者，其中包括 30 名患有 2 型糖尿病（T2D）但无肾脏并发症的患者、30 名 DKD 患者和 60 名健康对照者。对血液和尿液进行分析，以评估血脂和肝脏参数、ACR和估计肾小球滤过率（eGFR）。结果表明，与对照组相比，T2D 患者的 KIM-1 （p = 0.008）和 TNFR1 （p = 0.006）水平明显升高，而 DKD 患者的升高幅度更大（分别为 p = 0.003 和 p = 0.000）。与对照组相比，没有白蛋白尿升高的 T2D 患者的 KIM-1（p = 0.000）和 TNFR1（p = 0.001）水平明显升高。KIM-1 和 TNFR1 分别与 ACR（r = 0.400；p = 0.002 和 r = 0.607；p = 0.000）和 eGFR（r = -0.425；p = 0.001 和 r = -0.661；p = 0.000）相关。ROC曲线分析显示，TNFR1的曲线下面积（AUC）为0.91，KIM-1为0.76，ACR为0.95。结论血浆中 KIM-1 和 TNFR1 的水平是预测糖尿病患者肾脏疾病的有前途的生物标志物，它们与 ACR 的结合提高了整体诊断的准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Diabetes in Developing Countries ENDOCRINOLOGY & METABOLISM-

CiteScore

1.60

自引率

0.00%

发文量

109

审稿时长

6 months

期刊介绍： International Journal of Diabetes in Developing Countries is the official journal of Research Society for the Study of Diabetes in India. This is a peer reviewed journal and targets a readership consisting of clinicians, research workers, paramedical personnel, nutritionists and health care personnel working in the field of diabetes. Original research articles focusing on clinical and patient care issues including newer therapies and technologies as well as basic science issues in this field are considered for publication in the journal. Systematic reviews of interest to the above group of readers are also accepted.