Urinary monocyte chemoattractant protein-1 [MCP-1] correlates with prameters of renal injury in type II diabetes mellitus

ABSTRACT

Diabetic nephropathy [DN] is the leading cause of end stage renal disease in western world. Increased number of interstitial macrophages has been observed in biopsies from patients with DN. Monocyte chemoattractant protein-1 [MCP-1] is the strongest known chemotactic factor for monocytes and is upregulated in DN. We examined urinary level of MCP-1 in type 2 DM patients to assess the possible correlation between its level and the parameters of renal injury. Urinary MCP-1 level was assessed in 75 patients with type 2 DM [25 with and 25 without microabluminuria and 25 with macroalbuminuria and renal impairment] and compared with matched healthy control subjects. HBA1c and estimated glomerular filtration rate [eGFR] derived from the abbreviated Modification of Diet in Renal Disease [MDRD] equation were examined in the study groups in relation to the urinary MCP-1. urinary MCP-1 level was significantly higher in patients with micro and macroalbuminuria [167.4 +/- 50.23 and 630.87 +/- 318.10 ng/g creatinine respectively] as compared with normoalbuminuric patients and healthy controls [63.85 +/- 21.15 and 61.50 +/- 24.81 ng/g creatinine, p<0.0001]. MCP-1 correlated positively with urine albumin/creatinine ratio [ACR] [r=0.75, p<0.001], HBA1c [r=0.55, p<0.001] and inversely with eGFR [r=-0.60, p<0.001]. The study findings suggest that hyperglycemia is associated with increased urinary levels of MCP-1 that is closely linked to renal damage as reflected by proteinuria and eGFR levels. Collectively, these findings suggest that MCP-1 is involved in the pathogensis of diabetic nephropathy throughout its variable stages