The significance of detection of urinary podocalyxin, nephrin and monocyte chemoattractant protein-1 for diabetic nephropa-thy in newly diagnosed T2DM patients / 中国医师杂志

ABSTRACT

Objective To explore the significance of combined detection of urinary podocalyxin (PCX), nephrin and mono-cyte chemoattractant protein-1(MCP-1) for diabetic nephropathy in newly diagnosed type 2 diabetic patients.Methods A total of 132 newly diagnosed type 2 diabetes mellitus (T2DM) patients and 36 healthy subjects were recruited .The concentrations of urinary PCX (UPCX), nephrin (UNephrin) and MCP-1(UMCP-1) were measured with enzyme-linked immunosorbent assay (ELISA), and urina-ry UAE ( UAlb) concentration was measured with turbidimetric immunoassay method .All the results were shown by dividing the urine creatinine ( UCR) concentration in the same sample .The comparisons among UAlb/UCR, UPCX/UCR, UNephrin/UCR, and UMCP-1/UCR among groups were investigated .The correlation among UAlb/UCR, UPCX/UCR, UNephrin/UCR and UMCP-1/UCR was in-vestigated in T2DM patients.The comparison among positive rate of UMCP-1/UCR, UNephrin/UCR, UPCX/UCR and UAlb/UCR was investigated in T2DM patients.Results The levels of UPCX/UCR and UMCP-1/UCR were significantly higher in diabetes melli-tus(DM) group (37.37 ±22.83 and 47.19 ±29.98, respectively) than in healthy subjects (9.59 ±2.28 and 9.98 ±3.63, respec-tively) ( P <0.05 ) .The levels of UAlb/UCR、UPCX/UCR and UMCP-1/UCR were significantly higher in diabetic nephropathy (DN) group (90.39 ±59.35, 72.11 ±58.88, and 104.82 ±82.77, respectively) than in DM group (17.50 ±9.49, 37.37 ± 22.83 , and 47.19 ±29.98 , respectively ) and in healthy subjects ( 8.93 ±3.81 , 9.59 ±2.28 , and 9.98 ±3.63 , respectively ) ( P<0.05).The level of UNephrin/UCR was significantly higher in DN group (83.60 ±61.61) than in DM group (38.74 ±35.27) ( P <0.05).The levels of UPCX/UCR, UMCP-1/UCR, and UNephrin/UCR were positively correlated with UAlb/UCR ( r =0.619, 0.568, and 0.535, respectively) ( P <0.05) in T2DM patients.The level of UPCX/UCR was positively correlated with the levels of UMCP-1/UCR and UNephrin/UCR ( r =0.799 and 0.718 , respectively ) ( P <0.05 ) .The level of UNephrin/UCR was positively correlated with the level of UMCP-1/UCR ( r =0.635 P <0.05) in T2DM patients.The positive rate of UMCP-1/UCR, UNephrin/UCR, and UPCX/UCR was significantly higher than that of UAlb/UCR(χ2 =9.818, 6.673, and 5.395, respectively, P <0.05)in T2DM patients.Conclusions The combined detection of urinary PCX , Nephrin and MCP-1 is very important for the early renal dam-age in newly diagnosed type 2 diabetic patients .