Elevated Urinary VEGF-A, Transferrin, and Angiotensinogen Levels in Normoalbuminuric Children and Adolescents with Type 1 Diabetes: Can They Be Early Markers of Diabetic Kidney Disease?
| Autor: | Aydilek Dağdeviren Çakır, Seha Kamil Saygılı, Nur Canpolat, Dildar Konukoğlu, Hande Turan, Salim Çalışkan, Lale Sever, Oya Ercan, Olcay Evliyaoğlu |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Vascular Endothelial Growth Factor A Adolescent Endocrinology Diabetes and Metabolism Angiotensinogen Transferrin Endocrinology Cross-Sectional Studies Diabetes Mellitus Type 1 Pediatrics Perinatology and Child Health Humans Diabetic Nephropathies Female Child Biomarkers Glomerular Filtration Rate |
| Zdroj: | Hormone research in paediatrics. 94(11-12) |
| ISSN: | 1663-2826 |
| Popis: | Objective: We hypothesized that diabetic kidney disease (DKD) begins early, before albuminuria occurs. We therefore aimed to assess potential early urinary biomarkers of DKD in normoalbuminuric and normotensive children and adolescents with type 1 diabetes (T1D) to evaluate the relationship between these markers and clinical and laboratory risk factors for DKD. Methods: This cross-sectional study included 75 children and adolescents with T1D (62% females, mean age 13.9 ± 3.2 years) with normoalbuminuria (an albumin/creatinine ratio [ACR] below 30 mg/g creatinine). Fifty-five age- and sex-matched healthy children and adolescents served as controls. For the assessment of early DKD, urinary levels of angiotensinogen (AGT), transferrin, nephrin, vascular endothelial growth factor-A (VEGF-A), and kidney injury molecule-1 (KIM-1) were measured in adequately collected 24-h urine samples using enzyme-linked immunoassays. Results: The mean disease duration was 7.3 ± 3.2 (range 2.1–15.7) years, and the mean HbA1c level was 8.8 ± 1.4%. The median levels of urine VEGF-A/Cr, AGT/Cr, and transferrin/Cr were significantly higher in normoalbuminuric patients with T1D, compared with those of controls (p < 0.001, p = 0.02, and p = 0.001, respectively), but there was no difference in nephrin/Cr and KIM-1/Cr between the 2 groups. Although none of the patients had albuminuria, the median level of urine ACR was significantly higher in the patient group than the control group (p = 0.003). The ACR was positively correlated with glomerular filtration rate (GFR). Urinary transferrin/Cr, AGT/Cr, and VEGF-A/Cr were significantly correlated with ACR, but not with either GFR or diabetic risk factors including HbA1c or disease duration. Conclusion: Normoalbuminuric and normotensive children and adolescents with T1D have elevated urinary VEGF, AGT, and transferrin levels, which may indicate the development of DKD before albuminuria occurs. |
| Databáze: | OpenAIRE |
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