Wei Lan, Han Yuanyuan, Tu Chao
Department of Internal Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China.
Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Jan 12;16:117-128. doi: 10.2147/DMSO.S392888. eCollection 2023.
Diabetic kidney disease (DKD) affects an estimated 20-40% of type 2 diabetes patients and is among the most prevalent microvascular complications in this patient population, contributing to high morbidity and mortality rates. Currently, changes in albuminuria status are thought to be a primary indicator of the onset or progression of DKD, yet progressive nephropathy and renal impairment can occur in certain diabetic individuals who exhibit normal urinary albumin levels, emphasizing the lack of sensitivity and specificity associated with the use of albuminuria as a biomarker for detecting diabetic kidney disease and predicting DKD risk. According to the study, a non-invasive method for early detection or prediction of DKD may involve combining proteomic analytical techniques such second generation sequencing, mass spectrometry, two-dimensional gel electrophoresis, and other advanced system biology algorithms. Another category of proteins of relevance may now be provided by renal tissue biomarkers. The establishment of reliable proteomic biomarkers of DKD represents a novel approach to improving the diagnosis, prognostic evaluation, and treatment of affected patients. In the present review, a series of protein biomarkers that have been characterized to date are discussed, offering a theoretical foundation for future efforts to aid patients suffering from this debilitating microvascular complication.
糖尿病肾病(DKD)影响着约20%-40%的2型糖尿病患者,是该患者群体中最常见的微血管并发症之一,导致高发病率和死亡率。目前,蛋白尿状态的变化被认为是DKD发病或进展的主要指标,然而,在某些尿白蛋白水平正常的糖尿病个体中也可能发生进行性肾病和肾功能损害,这凸显了将蛋白尿用作检测糖尿病肾病和预测DKD风险的生物标志物时缺乏敏感性和特异性。根据该研究,一种用于早期检测或预测DKD的非侵入性方法可能涉及结合蛋白质组分析技术,如第二代测序、质谱分析、二维凝胶电泳以及其他先进的系统生物学算法。另一类相关蛋白质现在可能由肾组织生物标志物提供。建立可靠的DKD蛋白质组学生物标志物代表了一种改善受影响患者诊断、预后评估和治疗的新方法。在本综述中,讨论了一系列迄今为止已被鉴定的蛋白质生物标志物,为未来帮助患有这种使人衰弱的微血管并发症的患者的努力提供了理论基础。