Jung Chan-Young, Yoo Tae-Hyun
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
Kidney Res Clin Pract. 2022 Sep;41(Suppl 2):S46-S62. doi: 10.23876/j.krcp.22.084. Epub 2022 Sep 30.
Although diabetic kidney disease (DKD) remains one of the leading causes of reduced lifespan in patients with diabetes mellitus; its prevalence has failed to decline over the past 30 years. To identify those at high risk of developing DKD and disease progression at an early stage, extensive research has been ongoing in the search for prognostic and surrogate endpoint biomarkers for DKD. Although biomarkers are not used routinely in clinical practice or prospective clinical trials, many biomarkers have been developed to improve the early identification and prognostication of patients with DKD. Novel biomarkers that capture one specific mechanism of the DKD disease process have been developed, and studies have evaluated the prognostic value of assay-based biomarkers either in small sets or in combinations involving multiple biomarkers. More recently, several studies have assessed the prognostic value of omics- based biomarkers that include proteomics, metabolomics, and transcriptomics. This review will first describe the biomarkers used in current practice and their limitations, and then summarize the current status of novel biomarkers for DKD with respect to assay- based protein biomarkers, proteomics, metabolomics, and transcriptomics.
尽管糖尿病肾病(DKD)仍然是糖尿病患者寿命缩短的主要原因之一,但在过去30年中其患病率并未下降。为了早期识别那些发生DKD及疾病进展的高危人群,人们一直在进行广泛研究,以寻找DKD的预后和替代终点生物标志物。虽然生物标志物在临床实践或前瞻性临床试验中并非常规使用,但已经开发了许多生物标志物来改善DKD患者的早期识别和预后评估。已经开发出了能够捕捉DKD疾病过程中一种特定机制的新型生物标志物,并且研究已经在小样本或涉及多种生物标志物的组合中评估了基于检测的生物标志物的预后价值。最近,一些研究评估了基于组学的生物标志物的预后价值,这些生物标志物包括蛋白质组学、代谢组学和转录组学。本综述将首先描述当前实践中使用的生物标志物及其局限性,然后总结基于检测的蛋白质生物标志物、蛋白质组学、代谢组学和转录组学方面DKD新型生物标志物的现状。