Elhenawy Yasmine Ibrahim, Abdelmaksoud Abeer Ahmed, Ismail Eman Abdel Rahman, Elashmawy Zakaria Mostafa, Sallam Dina Ebrahem
Pediatric Departments, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Clinical Pathology Departments, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Expert Rev Endocrinol Metab. 2025 Jul;20(4):327-333. doi: 10.1080/17446651.2025.2492762. Epub 2025 Apr 13.
Epithelial-to-mesenchymal transition (EMT) may be involved in the pathogenesis of diabetic nephropathy (DN) among adults with type 2 diabetes. The current study aimed to evaluate the role of E-cadherin as a surrogate marker of EMT among children and adolescent with type 1 diabetes (T1D) and DN and its possible relation to carotid intima media thickness (CIMT).
Sixty participants with T1D were divided equally into two groups based on urinary albumin creatinine ratio (UACR) and compared with 30 healthy controls. Hemoglobin A1c (HbA1c), kidney function tests, serum E-cadherin and CIMT were assessed.
E-cadherin levels were significantly lower in patients with microalbuminuria (56.5 ± 15.8 ng/mL) compared with patients with normoalbuminuria (179.8 ± 45.1 ng/mL) and healthy controls (222.5 ± 39.9 ng/mL) ( < 0.001). E-cadherin correlated negatively with HbA1c ( = -0.42, = 0.001), UACR ( = -0.89, < 0.001) and CIMT ( = -0.716, < 0.001). ROC curve analysis showed that the E-cadherin cutoff value 135 ng/mL could detect nephropathy with 96.67% sensitivity and 86.67% specificity. Logistic regression showed that E-cadherin was a significant independent factor for nephropathy.
E-cadherin is a potential biomarker reflecting EMT activity in both pathogenesis and progression of DN and subclinical atherosclerosis in pediatric patients with T1D.
上皮-间质转化（EMT）可能参与2型糖尿病成年患者糖尿病肾病（DN）的发病机制。本研究旨在评估E-钙黏蛋白作为1型糖尿病（T1D）和DN儿童及青少年EMT替代标志物的作用及其与颈动脉内膜中层厚度（CIMT）的可能关系。
60例T1D参与者根据尿白蛋白肌酐比值（UACR）平均分为两组，并与30名健康对照者进行比较。评估糖化血红蛋白（HbA1c）、肾功能测试、血清E-钙黏蛋白和CIMT。
与正常白蛋白尿患者（179.8±45.1 ng/mL）和健康对照者（222.5±39.9 ng/mL）相比，微量白蛋白尿患者的E-钙黏蛋白水平显著降低（56.5±15.8 ng/mL）（<0.001）。E-钙黏蛋白与HbA1c（r=-0.42，P=0.001）、UACR（r=-0.89，P<0.001）和CIMT（r=-0.716，P<0.001）呈负相关。ROC曲线分析显示，E-钙黏蛋白临界值135 ng/mL检测肾病的灵敏度为96.67%，特异度为86.67%。逻辑回归显示，E-钙黏蛋白是肾病的显著独立因素。
E-钙黏蛋白是反映T1D儿童患者DN发病机制和进展以及亚临床动脉粥样硬化中EMT活性的潜在生物标志物。
