Noriaki Kurita1,2,3,4, Maki Kinoshita5, Maki Fujimura6, Kentaro Kurosawa6, Yui Sakuramachi6, Kiyoko Takano6, Shintaro Okamura6, Mako Kitatani6, Satoru Tsujii6, Edward C Norton7, Yasuaki Hayashino6. 1. Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan. kuritanoriaki@gmail.com. 2. Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan. kuritanoriaki@gmail.com. 3. Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan. kuritanoriaki@gmail.com. 4. Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan. kuritanoriaki@gmail.com. 5. Department of Clinical Laboratory, Tenri Hospital, Nara, Tenri, Japan. 6. Department of Endocrinology, Tenri Hospital, Nara, Tenri, Japan. 7. Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Abstract
BACKGROUND: A urinary biomarker sensitive to glomerular functional or structural changes in diabetic kidney disease is required. This study examined whether urinary C-megalin reflects renal function or albuminuria in diabetes. METHODS: This was a cross-sectional study involving 1576 patients with type 1 or 2 diabetes. The exposure variables were estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR), and the outcomes were urinary C-megalin excretion and concentration. Two-part models were used to examine the associations between eGFR and UACR with urinary C-megalin excretion or concentration. RESULTS: The UACR was linearly associated with urinary C-megalin excretion (per 100 mg/gCr of UACR; 11.8 fM/gCr [95% CI 8.9-14.7]). There was no association between decreasing eGFR and increasing urinary C-megalin excretion. The UACR was also linearly associated with the urinary C-megalin concentration (per 100 mg/gCr of UACR, 7.7 fM/L [95% CI 5.8-9.6]). At eGFR values > 60 mL/min/1.73 m2, the eGFR and urinary C-megalin concentration were inversely linearly related (per 10 mL/min/1.73 m2 decline, 7.7 fM/L [95% CI 0.2-15.1]). CONCLUSION: Urinary C-megalin excretion as well as concentration levels are potentially useful biomarkers to detect early changes in diabetic kidney disease.
BACKGROUND: A urinary biomarker sensitive to glomerular functional or structural changes in diabetic kidney disease is required. This study examined whether urinary C-megalin reflects renal function or albuminuria in diabetes. METHODS: This was a cross-sectional study involving 1576 patients with type 1 or 2 diabetes. The exposure variables were estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR), and the outcomes were urinary C-megalin excretion and concentration. Two-part models were used to examine the associations between eGFR and UACR with urinary C-megalin excretion or concentration. RESULTS: The UACR was linearly associated with urinary C-megalin excretion (per 100 mg/gCr of UACR; 11.8 fM/gCr [95% CI 8.9-14.7]). There was no association between decreasing eGFR and increasing urinary C-megalin excretion. The UACR was also linearly associated with the urinary C-megalin concentration (per 100 mg/gCr of UACR, 7.7 fM/L [95% CI 5.8-9.6]). At eGFR values > 60 mL/min/1.73 m2, the eGFR and urinary C-megalin concentration were inversely linearly related (per 10 mL/min/1.73 m2 decline, 7.7 fM/L [95% CI 0.2-15.1]). CONCLUSION: Urinary C-megalin excretion as well as concentration levels are potentially useful biomarkers to detect early changes in diabetic kidney disease.
Authors: Ony Araújo Galdino; Iago de Souza Gomes; Renato Ferreira de Almeida Júnior; Maria Imaculada Conceição Ferreira de Carvalho; Bento João Abreu; Marcela Abbott Galvão Ururahy; Barbara Cabral; Silvana Maria Zucolotto Langassner; Karla Simone Costa de Souza; Adriana Augusto de Rezende Journal: Sci Rep Date: 2022-10-20 Impact factor: 4.996