Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Lebanon; AUB Diabetes Program, Faculty of Medicine, American University of Beirut, Lebanon.
Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Lebanon.
J Adv Res. 2023 Feb;44:109-117. doi: 10.1016/j.jare.2022.04.013. Epub 2022 Apr 28.
The identification and validation of a non-invasive prognostic marker for early detection of diabetic kidney disease (DKD) can lead to substantial improvement in therapeutic decision-making.
The main objective of this study is to assess the potential role of the arachidonic acid (AA) metabolite 20-hydroxyeicosatetraenoic (20-HETE) in predicting the incidence and progression of DKD.
Healthy patients and patients with diabetes were recruited from the Hamad General Hospital in Qatar, and urinary 20-HETE levels were measured. Data analysis was done using the Statistical Package for Social Sciences (SPSS).
Our results show that urinary 20-HETE-to-creatinine (20-HETE/Cr) ratios were significantly elevated in patients with DKD when compared to patients with diabetes who did not exhibit clinical signs of kidney injury (p < 0.001). This correlation was preserved in the multivariate linear regression accounting for age, diabetes, family history of kidney disease, hypertension, dyslipidemia, stroke and metabolic syndrome. Urinary 20-HETE/Cr ratios were also positively correlated with the severity of kidney injury as indicated by albuminuria levels (p < 0.001). A urinary 20-HETE/Cr ratio of 4.6 pmol/mg discriminated between the presence and absence of kidney disease with a sensitivity of 82.2 % and a specificity of 67.1%. More importantly, a 10-unit increase in urinary 20-HETE/Cr ratio was tied to a 10-fold increase in the risk of developing DKD, suggesting a 20-HETE prognostic efficiency.
Taken together, our results suggest that urinary 20-HETE levels can potentially be used as non-invasive diagnostic and prognostic markers for DKD.
识别和验证糖尿病肾病 (DKD) 的非侵入性预后标志物可以显著改善治疗决策。
本研究的主要目的是评估花生四烯酸 (AA) 代谢物 20-羟二十碳四烯酸 (20-HETE) 在预测 DKD 发病和进展中的潜在作用。
从卡塔尔的哈马德综合医院招募了健康患者和糖尿病患者，并测量了尿液中的 20-HETE 水平。数据分析使用社会科学统计软件包 (SPSS) 完成。
我们的结果表明，与未出现肾脏损伤临床迹象的糖尿病患者相比，患有 DKD 的患者的尿液 20-HETE-肌酐 (20-HETE/Cr) 比值显著升高（p < 0.001）。在考虑年龄、糖尿病、肾脏疾病家族史、高血压、血脂异常、中风和代谢综合征的多元线性回归中保留了这种相关性。尿液 20-HETE/Cr 比值也与蛋白尿水平所指示的肾脏损伤严重程度呈正相关（p < 0.001）。尿液 20-HETE/Cr 比值为 4.6 pmol/mg 可区分有无肾脏疾病，其敏感性为 82.2%，特异性为 67.1%。更重要的是，尿液 20-HETE/Cr 比值增加 10 个单位与 DKD 发病风险增加 10 倍相关，表明 20-HETE 具有预后效率。
综上所述，我们的研究结果表明，尿液 20-HETE 水平可能可用作 DKD 的非侵入性诊断和预后标志物。
