Clinical significance of urinary Monocyte Chemoattractant Protein-1 [uMCP-1] in Indian type 2 diabetic patients at different stages of diabetic nephropathy

ABSTRACT

Monocyte Chemoattractant Protein-1 [MCP-1] is the strongest known chemotactic factor for monocytes and is upregulated in diabetic nephropathy. So measuring urinary MCP-1 is of great significance in the diagnosis and intervention of early diabetic nephropathy. This study aims at determining the levels of urinary MCP-1 [uMCP-1] at different stages of diabetic nephropathy and to see its correlation with other parameters in Indian type2 diabetic subjects. A total of 64 [MF; 4024] type 2 diabetic subjects were divided into three groups based on their renal function and were compared with non-diabetic controls [Group 1] n = 20 [MF; 137]. The study groups were Group 2 [normoalbuminuria] n = 16, Group 3 [microalbuminuria] n = 23 and Group 4 [macroalbuminuria] n = 25. Demographic, anthropometric and biochemical details were recorded for all the subjects. Urinary MCP-1 levels were measured by using solid phase ELISA method. Mean levels of uMCP-1 in subjects with type 2 diabetes were significantly higher than in controls [p < 0.05]. The levels of uMCP-1 in type 2 diabetic subjects increased gradually with deteriorating renal function [p = 0.006]. There was a significant difference in urinary MCP-1 levels between Group 2 and Group 1 [p < 0.001]. Levels of uMCP-1 were significantly higher in subjects with eGFR <60 ml/min compared to eGFR >60 ml/min [p = 0.008]. uMCP-1 levels correlated positively with uACR or uPCR [r = 0.551, p< 0.0001], urea [r = 0.43, p< 0.0001] and creatinine [r= 0.478, p< 0.0001]. A negative correlation between uMCP-1 and eGFR [r = -0.338, p = 0.006] was noted. Our study demonstrated that urinary MCP-1 levels increased gradually in type 2 diabetic subjects with deteriorating renal function. It is significantly associated with the other risk factors of diabetic nephropathy