Department of General Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Department of Biomedical Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Ann Afr Med. 2022 Apr-Jun;21(2):136-139. doi: 10.4103/aam.aam_92_20.
Diabetic nephropathy (DN) is a multifactorial disease, one of the most common complications of diabetes and a major cause of chronic kidney disease. Kidney injury molecule-1 (KIM-1) is a sensitive and specific marker of kidney injury as well as a predictor of prognosis.
The present study aimed to investigate the usefulness of serum KIM-1 as an early marker of DN.
The present study included total 75 participants, among whom 25 nondiabetic participants were chosen as controls. The 50 diabetic participants were divided into two groups according to urine protein/creatinine ratio (UPCR) as participants with normoalbuminuria (T2DM patients without nephropathy) and microalbuminuria (T2DM patients with nephropathy). The complete blood count, blood glucose, HbA1c, serum electrolytes, and creatinine levels were measured using standard laboratory techniques, and serum KIM-1 levels were measured by sandwich enzyme-linked immunosorbent assay.
There was a significant difference in the mean serum KIM-1 between the control and diabetics without microalbuminuria (P = 0.0001). Patients with longer duration of diabetes had a higher serum KIM-1 values (P = 0.05 in DM without microalbuminuria; P = 0.007 for DM with microalbuminuria). Serum KIM-1 did not correlate with UPCR in controls (P = ‒0.167), in diabetics with microalbuminuria (P = 0.487). However, there was a significant correlation observed between UPCR and serum KIM-1 in diabetics without microalbuminuria (P = 0.04).
The present study observed significantly increased levels of serum KIM-1 in both the diabetic groups compared to controls. Moreover, serum KIM-1 positively correlated with the duration of diabetes. Therefore, serum KIM-1 may be used as an early diagnostic marker to predict nephropathy among diabetes in our population.
糖尿病肾病（DN）是一种多因素疾病，是糖尿病最常见的并发症之一，也是慢性肾脏病的主要病因。肾损伤分子-1（KIM-1）是肾脏损伤的敏感和特异性标志物，也是预后的预测指标。
本研究旨在探讨血清 KIM-1 作为早期诊断 DN 的有用性。
本研究共纳入 75 名参与者，其中 25 名非糖尿病参与者被选为对照组。50 名糖尿病参与者根据尿蛋白/肌酐比值（UPCR）分为两组：正常白蛋白尿（无肾病的 2 型糖尿病患者）和微量白蛋白尿（有肾病的 2 型糖尿病患者）。采用标准实验室技术检测全血细胞计数、血糖、HbA1c、血清电解质和肌酐水平，并采用夹心酶联免疫吸附试验检测血清 KIM-1 水平。
对照组与无微量白蛋白尿的糖尿病患者之间的平均血清 KIM-1 水平存在显著差异（P = 0.0001）。糖尿病病程较长的患者血清 KIM-1 值较高（无微量白蛋白尿的 DM 中 P = 0.05；微量白蛋白尿的 DM 中 P = 0.007）。在对照组中，血清 KIM-1 与 UPCR 之间无相关性（P = -0.167），在微量白蛋白尿的糖尿病患者中也无相关性（P = 0.487）。然而，在无微量白蛋白尿的糖尿病患者中，UPCR 与血清 KIM-1 之间存在显著相关性（P = 0.04）。
本研究观察到两组糖尿病患者的血清 KIM-1 水平均显著升高，且血清 KIM-1 与糖尿病病程呈正相关。因此，血清 KIM-1 可作为预测本地区糖尿病患者发生肾病的早期诊断标志物。
