Keywords
Diabetic nephropathy
eGFR
UACR
How to Cite
Abstract
Podocalyxin, a glycosylated cell surface sialomucin of the CD34 family, is a kidney podocyte membrane negatively charged protein and the essential constituent of the glomerular basement membrane charge barrier. Additionally, it has a crucial role in maintaining the glomerular filtration barrier permeability. It has been considered that one of the most important factors in diabetic nephropathy is podocyte injury. In the natural history of diabetic nephropathy and macrovascular complications, podocytes have been shown to be structurally and functionally affected. The current study aimed to determine serum podocalyxin levels in patients with type 2 diabetes mellitus and to analyse its relation to glomerular filtration rate and albuminuria. This cross-sectional study was performed at the diabetic center in Azadi Teaching Hospital and Golan Hospital in Dohuk city from September 2021 to March 2022. Consecutive sampling was applied to select 200 subjects (case group) with T2DM aged 30-65 years and 93 healthy subjects (control group). BMI, eGFR, albuminuria, HbA1c, and serum podocalyxin levels were measured for all study subjects. Serum podocalyxin levels were significantly higher in the case group (P =0.019). There was no significant difference in serum podocalyxin levels between case groups (normoalbuminuria, microalbuminuria, and macroalbuminuria). A significant negative correlation between eGFR and serum podocalyxin was found in both control and case group (P =0.010 r =-0.267, P =0.030 r =-0.154, respectively). Although S.PCX levels had a significant difference between the case and control group and a significant negative correlation with eGFR, it may not be considered as a diabetic nephropathy biomarker.
References
Agarwal, R. (2009). Diabetic nephropathy, proteinuria, and progression of CKD. Clin J Am Soc Nephrol, 4, 1523-1528.
Akankwasa, G., Jianhua, L., Guixue, C., Changjuan, A., Xiaosong, Q. (2018). Urine markers of podocyte dysfunction: a review of podocalyxin and nephrin in selected glomerular diseases. Biomarkers in Medicine, 12(8), 927-935.
Al-Rubeaan, K., Siddiqui, K., Al-Ghonaim, M.A., Youssef, A.M., Al-Sharqawi, A.H., Al Naqeb, D. (2017). Assessment of the diagnostic value of different biomarkers in relation to various stages of diabetic nephropathy in type 2 diabetic patients. Scientific Reports, 7(1), 1-9.
Barutta, F., Bellini, S., Canepa, S., Durazzo, M., Gruden, G. (2021). Novel biomarkers of diabetic kidney disease: current status and potential clinical application. Acta Diabetologica, 58(7), 819-830.
Betsholtz, C., He, L., Takemoto, M., Norlin, J., Sun, Y., Patrakka, J., Tryggvason, K. (2007). The glomerular transcriptome and proteome. Nephron Experimental Nephrology, 106(2), e32-e36.
Chida, S., Fujita, Y., Ogawa, A., Hayashi, A., Ichikawa, R., Kamata, Y., Shichiri, M. (2016). Levels of albuminuria and risk of developing macroalbuminuria in type 2 diabetes: historical cohort study. Scientific Reports, 6(1), 1-8.
Cole, J.B., Florez, J.C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature Reviews Nephrology, 16(7), 377-390.
Doyonnas, R., Kershaw, D.B., Duhme, C., Merkens, H., Chelliah, S., Graf, T., McNagny, K.M. (2001). Anuria, omphalocele, and perinatal lethality in mice lacking the CD34-related protein podocalyxin. J Exp Med, 194, 13-27.
El-Ashmawy, H.M., Selim, F.O., Hosny, T.A., Almassry, H.N. (2019). Association of serum podocalyxin levels with peripheral arterial disease in patients with type 2 diabetes. Journal of Diabetes and its Complications, 33(7), 495-499.
Ghorab, A.A. E., Diab, M.E., Abdelfattah, N.R., Elmenshawy, W.R. (2020). Study of Urinary Podocalyxin as an Early Biomarker in Diabetic Nephropathy. The Egyptian Journal of Hospital Medicine, 80(1), 627-632.
Hara, M., Yamagata, K., Tomino, Y., Saito, A., Hirayama, Y., Ogasawara, S., Yan, K. (2012). Urinary podocalyxin is an early marker for podocyte injury in patients with diabetes: establishment of a highly sensitive ELISA to detect urinary podocalyxin. Diabetologia, 55(11), 2913-2919.
Ijpelaar, D.H., Schulz, A., Koop, K., Schlesener, M., Bruijn, J.A., Kerjaschki, D., de Heer, E. (2008). Glomerular hypertrophy precedes albuminuria and segmental loss of podoplanin in podocytes in Munich-Wistar-Fromter rats. American Journal of Physiology-Renal Physiology, 294(4), F758-F767.
Kostovska, I., Trajkovska, K.T., Cekovska, S., Topuzovska, S., Kavrakova, J.B., Spasovski, G., Labudovic, D. (2020). Role of urinary podocalyxin in early diagnosis of diabetic nephropathy. Romanian Journal of Internal Medicine, 58(4), 233-241.
Lee, S.Y., Choi, M.E. (2015). Urinary biomarkers for early diabetic nephropathy: beyond albuminuria. Pediatric Nephrology, 30(7), 1063-1075.
Li, Z., Xu, Y., Liu, X., Nie, Y., Zhao, Z. (2017). Urinary heme oxygenase1 as a potential biomarker for early diabetic nephropathy. Nephrology, 22(1), 58-64.
Mohamed, A.H., Heibah, H.A., Ibrahim, H.E., Abdeen, H.M., Badawy, A. (2016). Urinary podocalyxin; a potential new marker for early diabetic nephropathy in type 2 diabetes mellitus. Indian Journal of Applied Research, 6(1), 246-250
Nah, E.H., Cho, S., Kim, S., Cho, H.I. (2017). Comparison of urine albumin-to-creatinine ratio (ACR) between ACR strip test and quantitative test in prediabetes and diabetes. Annals of Laboratory Medicine, 37(1), 28.
Porrini, E., Ruggenenti, P., Mogensen, C.E., Barlovic, D.P., Praga, M., Cruzado, J.M., ERA-EDTA Diabesity Working Group. (2015). Non-proteinuric pathways in loss of renal function in patients with type 2 diabetes. The Lancet Diabetes & Endocrinology, 3(5), 382-391.
Roden, M., Shulman, G.I. (2019). The integrative biology of type 2 diabetes. Nature, 576(7785), 51-60.
Shelbaya, S.E.D.A., Ibrahim, R.H., Sawirs, N.S., Ali, H.M. (2020). Study of The Podocalyxin as an early marker for diabetic nephropathy and its correlation with stages of diabetic nephropathy in a sample of Egyptian patients with T2DM. The Egyptian Journal of Hospital Medicine, 81(5), 2099-2102.
Shoji, M., Kobayashi, K., Takemoto, M., Sato, Y., Yokote, K. (2016). Urinary podocalyxin levels were associated with urinary albumin levels among patients with diabetes. Biomarkers, 21(2), 164-167.
Le Tran, N., Wang, Y., Nie, G. (2021). Podocalyxin in normal tissue and epithelial cancer. Cancers, 13(12), 2863.
Weir, C.B., & Jan, A. (2022). BMI classification percentile and cut off points. [Updated 2021 Jun 29]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Available from https://www. ncbi. nlm. nih. gov/books/NBK541070.
Xie, Y., Jin, D., Qiu, H., Lin, L., Sun, S., Li, D., Jia, M. (2021). Assessment of urinary podocalyxin as an alternative marker for urinary albumin creatinine ratio in early stage of diabetic kidney disease in older patients. Nefrolog 952, 107.
Ye, H., Bai, X., Gao, H., Li, L., Wu, C., Sun, X., Lu, Z. (2014). Urinary podocalyxin positive-element occurs in the early stage of diabetic nephropathy and is correlated with a clinical diagnosis of diabetic nephropathy. Journal of Diabetes and its Complications, 28(1), 96-100.
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