Nugroho Pringgodigdo, Saragih Riahdo Juliarman, Lydia Aida, Muhadi Muhadi, Isbagio Harry, Shatri Hamzah, Chundiawan Carissa Cornelia, Hermanto Fidel
Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia-Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia-Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Int J Nephrol Renovasc Dis. 2024 Oct 22;17:255-264. doi: 10.2147/IJNRD.S476395. eCollection 2024.
Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease, and podocytopathy is an early manifestation of DKD characterized by the urinary excretion of podocyte-specific proteins, such as nephrin and podocin. Asymmetric dimethylarginine (ADMA)-a biomarker of endothelial dysfunction-is associated with progressive kidney dysfunction. However, the mechanism of endothelial dysfunction in DKD progression is unclear. The aim of this study was to investigate the correlations of ADMA levels with nephrin, podocin, and the podocin:nephrin ratio (PNR) in DKD patients.
A cross-sectional study of 41 DKD outpatients was performed in two hospitals in Jakarta from April-June 2023. The collected data included the subjects' characteristics, histories of disease and medication, and relevant laboratory data. Serum ADMA was measured using liquid chromatography, while urinary podocin and nephrin were measured using the enzyme-linked immunosorbent assay (ELISA) method. A correlation analysis was performed to evaluate the correlation of ADMA with nephrin, podocin, and PNR. Regression analysis was performed to determine confounding factors.
The mean value of ADMA was 70.2 (SD 17.2) ng/mL, the median for nephrin was 65 (20-283 ng/mL), and the median of podocin was 0.505 (0.433-0.622) ng/mL. ADMA correlated significantly with nephrin ( = 0.353, = 0.024) and PNR ( = -0.360, = 0.021), but no correlation was found between ADMA and podocin ( = 0.133, = 0.409). The multivariate analysis showed that body mass index was a confounding factor.
This study revealed weak positive correlations between ADMA and urinary nephrin and between ADMA and PNR. No correlation was found between ADMA and urinary podocin.
糖尿病肾病（DKD）是终末期肾病的主要病因，足细胞病是DKD的早期表现，其特征是尿中排泄足细胞特异性蛋白，如nephrin和podocin。不对称二甲基精氨酸（ADMA）——一种内皮功能障碍的生物标志物——与进行性肾功能不全相关。然而，DKD进展过程中内皮功能障碍的机制尚不清楚。本研究的目的是探讨DKD患者中ADMA水平与nephrin、podocin以及podocin:nephrin比值（PNR）之间的相关性。
2023年4月至6月在雅加达的两家医院对41例DKD门诊患者进行了横断面研究。收集的数据包括受试者的特征、疾病史和用药史以及相关实验室数据。采用液相色谱法测定血清ADMA，采用酶联免疫吸附测定（ELISA）法测定尿podocin和nephrin。进行相关性分析以评估ADMA与nephrin、podocin和PNR之间的相关性。进行回归分析以确定混杂因素。
ADMA的平均值为70.2（标准差17.2）ng/mL，nephrin的中位数为65（20 - 283 ng/mL），podocin的中位数为0.505（0.433 - 0.622）ng/mL。ADMA与nephrin显著相关（r = 0.353，P = 0.024）和PNR显著相关（r = -0.360，P = 0.021），但未发现ADMA与podocin之间存在相关性（r = 0.133，P = 0.409）。多变量分析表明体重指数是一个混杂因素。
本研究揭示了ADMA与尿nephrin之间以及ADMA与PNR之间存在弱正相关。未发现ADMA与尿podocin之间存在相关性。
