Association between lipoprotein-associated phospholipase A2 and 25-hydroxy-vitamin D on early stage diabetic kidney disease in patients with type-2 diabetes mellitus.

OBJECTIVE

This study aimed to analyse the association between lipoprotein-associated phospholipase A2 (Lp-PLA2) and 25-hydroxy-vitamin D (25[OH]D) and early diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM) and evaluate the potential roles of these two biomarkers in the clinical diagnosis of DKD.

METHODS

A total of 422 inpatients with T2DM were retrospectively enrolled between January 2018 and March 2022 at the First Affiliated Hospital of Nanjing Medical University. The baseline clinical parameters of each patient were determined, and their demographic characteristics were extracted from the hospital information system. The patients were separated into groups according to serum Lp-PLA2 and 25(OH)D levels and binary logistic regression analysis was used to determine independent predictors of early DKD incidence.

RESULTS

Levels of Lp-PLA2 significantly increased and those of 25(OH)D significantly decreased with DKD progression (both  < 0.001). Lp-PLA2 concentrations were positively correlated with albuminuria levels (r = 0.37,  < 0.001), whereas 25(OH)D levels were negatively correlation (r = -0.34,  < 0.001). The incidence of DKD was higher in the Lp-PLA2 elevated and 25(OH)D deficient groups (all  < 0.001). Body mass index, systemic immune-inflammatory index, serum uric acid, C-peptide, and triglyceride-glucose indices were positively associated with Lp-PLA2 levels (all  < 0.001) and negatively associated with 25(OH)D (all  < 0.05). Furthermore, Lp-PLA2 was an independent risk factor ( = 1.003,  = 0.015), and 25(OH)D was an independent protective factor ( = 0.937,  = 0.008) for early DKD occurrence in binary logistic regression analysis. The area under the curve for the combination of Lp-PLA2 and 25(OH)D for diagnosing DKD was 0.867, with a sensitivity of 70.4 % and a specificity of 89.5 %.

CONCLUSIONS

Increased serum Lp-PLA2 and decreased 25(OH)D levels are risk factors for early DKD in patients with T2DM. The combined detection of Lp-PLA2 and 25(OH)D may enhance the diagnostic efficacy of DKD.