Correlation Between Circulating Visfatin and Nitric Oxide Metabolites Levels in Patients With Diabetic Nephropathy.

INTRODUCTION: Diabetic nephropathy is one of the serious complications of diabetes mellitus. Visfatin is an intracellular enzyme with insulin-mimicking effects. It enhances the expression of endothelial nitric oxide (NO) synthase in renal cells. This study aimed to investigate serum levels of visfatin and NO metabolites in patients with diabetic nephropathy. MATERIALS AND METHODS: A total of 80 diabetic patients were enrolled and classified into nephropathic and non-nephropathic patients. Serum visfatin and insulin levels were estimated using an enzyme-linked immunosorbent assay, and NO metabolites were estimated using a colorimetric assay. RESULTS: Serum visfatin and NO metabolites levels were significantly elevated in the patients with diabetic nephropathy. Serum visfatin levels and NO metabolites were significantly higher in the nephropathic patients (P = .003; 95% confidence interval, 2.29 to 10.81; P < .001; 95% confidence interval, 3.14 to 9.46, respectively) as compared to the control group, whereas homeostatic model assessment-insulin resistance was significantly lower (P = .02; 95% confidence interval, -1.51 to -1.01).There was no correlation between body mass index, blood pressure, lipid profile, insulin, and glucose levels and serum visfatin and NO metabolites levels. CONCLUSIONS: The results of this study demonstrated that there were high levels of visfatin and NO metabolites in patients with diabetic nephropathy. In addition, there was a positive correlation between visfatin and NO metabolites levels in nephropathic and non-nephropathic diabetic patients.

Association Between Matrix Metalloproteinase-3 Activity and Glomerular Filtration Rate and Albuminuria Status in Patients With Type 2 Diabetes Mellitus.

INTRODUCTION: Diabetic nephropathy is pictured as matrix accumulation and thickening of glomerular basal membrane. Matrix metalloproteinases (MMPs) are major proteases involved in extracellular matrix degradation. Moreover, plasminogen activator inhibitor-1 (PAI-1) primarily regulates plasmin dependent proteolysis. It plays a role in renal fibrosis causing extracellular matrix accumulation through inhibition of plasmin-dependent extracellular matrix degradation. This study investigated PAI-1 serum level and MMP-3 activity and their correlation with glomerular filtration rate in patients with diabetes mellitus. MATERIALS AND METHODS: In a case-control design, serum PAI-1 concentrations and MMP-3 activity were measured in 80 patients with normoalbuminuria, microalbuminuria, and macroalbuminuria. Receiver operating characteristics curve analysis was used to assess the diagnostic accuracy of MMP-3 activity in discriminating albuminuria. RESULTS: In the patients with microalbuminuria, serum PAI-1 levels were higher compared with macroalbuminuric patients (P < .001). The patients with macroalbuminuria exhibited a significantly lower MMP-3 activity than the patients with microalbuminuria and normoalbuminuria (P < .001). No significant correlation was found between serum MMP-3 activity and serum PAI-1 levels in those with normoalbuminuria, microalbuminuria, and macroalbuminuria. The MMP-3 activity had a strong positive correlation with estimated glomerular filtration (r = 0.853, P < .001). CONCLUSIONS: We found that there was a positive correlation between glomerular filtration rate and MMP-3 activity in diabetic patients. This concludes that MMP-3 may have a role in the pathogenesis of diabetic nephropathy progressions towards macroalbuminuria, and therefore, MMP-3 activity may be used in evaluating albuminuria status.