Abdelsattar S, Kasemy Z A, Elsayed M, Elrahem T A, Zewain S K
Clinical Biochemistry and Molecular Diagnostics Department, National Liver Institute, Menoufia University, Shibin El Kom, Egypt.
Menoufia Faculty of Medicine, Public Health and Community Medicine, Shibin El Kom, Egypt.
Br J Biomed Sci. 2021 Oct;78(4):184-190. doi: 10.1080/09674845.2021.1894705. Epub 2021 May 10.
: Diabetic kidney disease (DKD) is an increasing health problem and an extra burden to health services. The study of characteristic metabolic alterations of DKD is crucial for a better understanding of pathogenesis to identify new potential biomarkers and drug targets. We hypothesized that metabolic profiling of amino acids, acylcarnitines, and organic acids are useful new biomarkers for the diagnosis of the early stages of DKD The hypothesis was testing in a case-control study of 232 patients with type 2 diabetes mellitus and 150 healthy controls. Patients were classified according to urinary albumin and estimated glomerular filtration rate (eGFR) into 100 with normoalbuminuria and 132 with microalbuminuria group. Eighteen AcylCNs and 17 amino acids were measured in the blood by tandem mass spectrometry while 17 urinary organic acids were quantitatively measured by gas chromatography - mass spectrometry. Regression analysis found that dodecanoylcarnitines C12 (effect size 2.03 [95%CI 1.73-2.32]), triglylcarnitine C5:1 (2.01 [1.70-2.30]), and isovalerylcarnitine C5 (1.78 [1.48-2.07]) were stronger predictors of albumin/creatinine ratio than HbA1c (1.50 [1.20-1.78]) and hence they could serve as potential biomarkers for the diagnosis of the early stages of DKD. Targeted metabolic profiling offers a new, non-invasive approach for detecting biomarkers for the early diagnosis of DKD suggesting new pathogenetic phases that might be new targets for treatment.
糖尿病肾病（DKD）是一个日益严重的健康问题，给医疗服务带来了额外负担。研究DKD的特征性代谢改变对于更好地理解发病机制、识别新的潜在生物标志物和药物靶点至关重要。我们假设氨基酸、酰基肉碱和有机酸的代谢谱是诊断DKD早期阶段有用的新生物标志物。该假设在一项针对232例2型糖尿病患者和150例健康对照的病例对照研究中进行了检验。患者根据尿白蛋白和估计肾小球滤过率（eGFR）分为100例正常白蛋白尿组和132例微量白蛋白尿组。通过串联质谱法测定血液中的18种酰基肉碱和17种氨基酸，同时通过气相色谱 - 质谱法定量测定17种尿有机酸。回归分析发现，十二烷酰肉碱C12（效应大小2.03 [95%CI 1.73 - 2.32]）、三甘酰肉碱C5:1（2.01 [1.70 - 2.30]）和异戊酰肉碱C5（1.78 [1.48 - 2.07]）比糖化血红蛋白（HbA1c，1.50 [1.20 - 1.78]）更能预测白蛋白/肌酐比值，因此它们可作为诊断DKD早期阶段的潜在生物标志物。靶向代谢谱分析为检测DKD早期诊断的生物标志物提供了一种新的非侵入性方法，提示了可能成为新治疗靶点的新发病阶段。
