Chiang Yu-Hsin, Li Yu-Hsuan, Chan Yin-Ching, Cheng Yu-Cheng, Wu Junyi, Lin Jer-An, Huang Wei-Chang, Lee I-Te
Department of Education, Taichung Veterans General Hospital, Taichung, Taiwan.
School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Front Endocrinol (Lausanne). 2024 Sep 17;15:1403717. doi: 10.3389/fendo.2024.1403717. eCollection 2024.
Patients with type 2 diabetes mellitus (DM) have a high prevalence of chronic kidney disease (CKD). Energy imbalance and inflammation may be involved in the pathogenesis of CKD. We examined the effects of brain-derived neurotrophic factor (BDNF) and vascular cell adhesion molecule-1 (VCAM-1) on CKD in patients with type 2 DM.
Patients with type 2 DM were enrolled for this cross-sectional study. Fasting serum was prepared to measure the BDNF and VCAM-1 levels. An estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m was used as the criterion for identifying patients with CKD.
Of the 548 enrolled participants, 156 had CKD. Patients with CKD exhibited significantly lower BDNF (median of 21.4 ng/mL, interquartile range [IQR]: 17.0-27.0 ng/mL vs. median of 25.9 ng/mL, IQR: 21.0-30.4 ng/mL, 0.001) and higher VCAM-1 (median of 917 ng/mL, IQR: 761-1172 ng/mL vs. median of 669 ng/mL, IQR: 552-857 ng/mL, 0.001) levels than those without CKD. Serum BDNF levels were inversely correlated with VCAM-1 levels (Spearman's rank correlation coefficient = -0.210, 0.001). The patients were divided into four subgroups based on median BDNF and VCAM-1 levels (24.88 ng/mL and 750 ng/mL, respectively). Notably, patients in the high VCAM-1 and low BDNF group had the highest prevalence (50%) of CKD. Multivariate logistic regression revealed a significantly higher odds ratio (OR) of CKD in the high VCAM-1 and low BDNF group (OR = 3.885, 95% CI: 1.766-8.547, 0.001), followed by that in the high VCAM-1 and high BDNF group (OR = 3.099, 95% CI: 1.373-6.992, =0.006) compared with that in the low VCAM-1 and high BDNF group. However, the risk of CKD in the low VCAM-1 and low BDNF group was not significantly different from that in the low VCAM-1 and high BDNF group ( =0.266).
CKD in patients with type 2 DM is associated with low serum BDNF and high VCAM-1 levels. BDNF and VCAM-1 have a synergistic effect on CKD. Thus, BDNF and VCAM-1 can be potential biomarkers for CKD risk stratification in patients with type 2 DM.
2型糖尿病（DM）患者慢性肾脏病（CKD）的患病率很高。能量失衡和炎症可能参与CKD的发病机制。我们研究了脑源性神经营养因子（BDNF）和血管细胞黏附分子-1（VCAM-1）对2型DM患者CKD的影响。
招募2型DM患者进行这项横断面研究。制备空腹血清以测量BDNF和VCAM-1水平。估计肾小球滤过率（eGFR）<60 mL/min/1.73 m²被用作识别CKD患者的标准。
在548名登记参与者中，156人患有CKD。CKD患者的BDNF水平显著较低（中位数为21.4 ng/mL，四分位间距[IQR]：17.0 - 27.0 ng/mL，而无CKD患者中位数为25.9 ng/mL，IQR：21.0 - 30.4 ng/mL，P = 0.001），VCAM-1水平较高（中位数为917 ng/mL，IQR：761 - 1172 ng/mL，而无CKD患者中位数为669 ng/mL，IQR：552 - 857 ng/mL，P = 0.001）。血清BDNF水平与VCAM-1水平呈负相关（Spearman等级相关系数 = -0.210，P = 0.001）。根据BDNF和VCAM-1水平中位数（分别为24.88 ng/mL和750 ng/mL）将患者分为四个亚组。值得注意的是，高VCAM-1和低BDNF组患者的CKD患病率最高（50%）。多因素逻辑回归显示，高VCAM-1和低BDNF组CKD的优势比（OR）显著更高（OR = 3.885，95%可信区间：1.766 - 8.547，P = 0.001），其次是高VCAM-1和高BDNF组（OR = 3.099，95%可信区间：1.373 - 6.992，P = 0.006），与低VCAM-1和高BDNF组相比。然而，低VCAM-1和低BDNF组CKD的风险与低VCAM-1和高BDNF组无显著差异（P = 0.266）。
2型DM患者的CKD与血清BDNF水平低和VCAM-1水平高有关。BDNF和VCAM-1对CKD有协同作用。因此，BDNF和VCAM-1可能是2型DM患者CKD风险分层的潜在生物标志物。
