Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan.
Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
J Diabetes Complications. 2021 Apr;35(4):107848. doi: 10.1016/j.jdiacomp.2021.107848. Epub 2021 Jan 7.
Since diabetes-associated kidney complication changes from diabetic nephropathy to diabetic kidney disease (DKD), more suitable biomarkers than urinary albumin are required. It has been hypothesized that urinary adiponectin (u-ADPN) is associated with the progression of DKD. We therefore evaluated the effectiveness of u-ADPN in predicting the decline of the renal function in patients with diabetes prior to end-stage renal disease.
An ultrasensitive immune complex transfer enzyme immunoassay (ICT-EIA) was used to measure total and high molecular weight (HMW) adiponectin separately. We evaluated the relationships between the creatinine-adjusted urinary total-ADPN and HMW-ADPN, albumin (UACR) and liver-type fatty acid binding protein (L-FABP) at baseline and the 2-year change of the estimated glomerular filtration rate (ΔeGFR).
This 2-year prospective observational study included 201 patients with diabetes. These patients were divided into three groups according to their ΔeGFR: ≤-10 mL/min/1.73m, >-10 and ≤0 mL/min/1.73m, and >0 mL/min/1.73m. Jonckheere-Terpstra test showed that lower ΔeGFR was associated with higher u-HMW-ADPN (p = 0.045). In logistic regression analysis, u-HMW-ADPN was associated with ΔeGFR after adjusted age, sex, and basal eGFR.
Urinary HMW-ADPN could predict a declining renal function in patients with diabetes.
由于糖尿病相关的肾脏并发症已经从糖尿病肾病转变为糖尿病肾脏疾病（DKD），因此需要比尿白蛋白更合适的生物标志物。有人假设尿脂联素（u-ADPN）与 DKD 的进展有关。因此，我们评估了 u-ADPN 在预测糖尿病患者肾功能下降方面的有效性，这些患者尚未进展到终末期肾病。
采用超敏免疫复合物转移酶免疫分析法（ICT-EIA）分别测定总脂联素和高分子量（HMW）脂联素。我们评估了基线时肌酐校正的尿总脂联素和 HMW 脂联素与白蛋白（UACR）和肝型脂肪酸结合蛋白（L-FABP）之间的关系，以及估计肾小球滤过率（eGFR）的 2 年变化（ΔeGFR）。
这项为期 2 年的前瞻性观察性研究纳入了 201 名糖尿病患者。根据他们的 ΔeGFR 将这些患者分为三组：≤-10 mL/min/1.73m、>-10 且≤0 mL/min/1.73m 和 >0 mL/min/1.73m。Jonckheere-Terpstra 检验显示，较低的 ΔeGFR 与较高的 u-HMW-ADPN 相关（p=0.045）。在逻辑回归分析中，u-HMW-ADPN 与调整年龄、性别和基础 eGFR 后的 ΔeGFR 相关。
尿 HMW-ADPN 可预测糖尿病患者肾功能下降。
