Hou Ning-Ning, Kan Cheng-Xia, Huang Na, Liu Yong-Ping, Mao En-Wen, Ma Yu-Ting, Han Fang, Sun Hong-Xi, Sun Xiao-Dong
Department of Endocrinology, Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China.
Department of Pathology, Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China.
World J Diabetes. 2021 Jan 15;12(1):47-55. doi: 10.4239/wjd.v12.i1.47.
Diabetic kidney disease is a microvascular complication of diabetes with complex pathogenesis. Wingless signaling-mediated renal fibrosis is associated with diabetic kidney disease. Dickkopf-1, a negative regulator of Wingless, has been proven to participate in renal fibrosis, glucose metabolism, and inflammation. However, whether serum Dickkopf-1 levels are associated with diabetic kidney disease remains unclear.
To assess the relationship between serum Dickkopf-1 levels and albuminuria in individuals with type 2 diabetes.
Seventy-three type 2 diabetes patients and 24 healthy individuals were enrolled in this case-control study. Diabetic individuals were separated into normal albuminuria, microalbuminuria, and macroalbuminuria groups based on their urinary albumin/creatinine ratios (UACRs). Clinical characteristics and metabolic indices were recorded. Serum Dickkopf-1 levels were determined by enzyme-linked immunosorbent assay.
No significant difference in serum Dickkopf-1 levels was found between healthy individuals and the normal albuminuria group. However, the levels in the microalbuminuria group were significantly lower than those in the normal albuminuria group ( = 0.017), and those in the macroalbuminuria group were the lowest. Bivariate analysis revealed that serum Dickkopf-1 levels were positively correlated with hemoglobin A1c level ( = 0.368, < 0.01) and estimated glomerular filtration rate ( = 0.339, < 0.01), but negatively correlated with diabetes duration ( = -0.231, = 0.050), systolic blood pressure ( = -0.369, = 0.001), serum creatinine level ( = -0.325, < 0.01), and UACR ( = -0.459, < 0.01). Multiple and logistic regression showed that serum Dickkopf-1 levels were independently associated with UACR (odds ratio = 0.627, = 0.021).
Serum Dickkopf-1 levels are negatively associated with UACR. Lower serum Dickkopf-1 levels could be a critical risk factor for albuminuria in diabetes.
糖尿病肾病是糖尿病的一种微血管并发症，其发病机制复杂。无翅信号介导的肾纤维化与糖尿病肾病相关。Dickkopf-1是无翅信号的负调节因子，已被证明参与肾纤维化、糖代谢和炎症反应。然而，血清Dickkopf-1水平是否与糖尿病肾病相关仍不清楚。
评估2型糖尿病患者血清Dickkopf-1水平与蛋白尿之间的关系。
本病例对照研究纳入了73例2型糖尿病患者和24例健康个体。根据尿白蛋白/肌酐比值（UACR）将糖尿病个体分为正常蛋白尿组、微量白蛋白尿组和大量白蛋白尿组。记录临床特征和代谢指标。采用酶联免疫吸附测定法测定血清Dickkopf-1水平。
健康个体与正常蛋白尿组血清Dickkopf-1水平无显著差异。然而，微量白蛋白尿组的水平显著低于正常蛋白尿组（P = 0.017），大量白蛋白尿组的水平最低。双变量分析显示，血清Dickkopf-1水平与糖化血红蛋白水平呈正相关（r = 0.368，P < 0.01）和估计肾小球滤过率呈正相关（r = 0.339，P < 0.01），但与糖尿病病程呈负相关（r = -0.231，P = 0.050）、收缩压呈负相关（r = -0.369，P = 0.001）、血清肌酐水平呈负相关（r = -0.325，P < 0.01）和UACR呈负相关（r = -0.459，P < 0.01）。多元和逻辑回归显示，血清Dickkopf-1水平与UACR独立相关（比值比 = 0.627，P = 0.021）。
血清Dickkopf-1水平与UACR呈负相关。较低的血清Dickkopf-1水平可能是糖尿病患者蛋白尿的关键危险因素。
