Journal
FREE RADICAL BIOLOGY AND MEDICINE
Volume 178, Issue -, Pages 1-6Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.freeradbiomed.2021.11.021
Keywords
Tetrahydrobiopterin; Kidney function; Albuminuria; ACR; Diabetes
Funding
- National Science Foundation of China [81170767, 81571376]
- Chinese Medical Association [13060906481]
- Fundamental Research Funds for the Central Universities [2042020kf1079]
- Talent Research Grant for Diabetes Study from China International Medical Foundation [2017]
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The study utilized an LC-MS/MS method to measure plasma BH4 levels in diabetes patients and found a correlation between BH4 levels and ACR and eGFR, suggesting its potential as a biomarker for kidney injury in diabetes.
Objective: The clinical research on BH4 is limited because of the difficulties on its measurement. In this study, we used our own established LC-MS/MS method to examine the plasma BH4 levels in diabetes to determine whether it could be used as a biomarker for the prediction of kidney injury in those patients. Methods: Hospitalized diabetes patients in Renmin Hospital of Wuhan University from Jan to Aug 2021 were recruited. To assess the association between plasma BH4 with ACR or eGFR in diabetes, a total of 142 patients with type 2 diabetes (T2DM) were enrolled. They were divided into three groups by albuminuria levels: normoalbuminuria (n = 68), microalbuminuria (n = 48), and macroalbuminuria (n = 26) according to ACR; or into two groups by eGFR: eGFR 0.001) and CP-2h (B = -0.257, P = 0.028) were independently associated with ACR progression. ROC curve showed that BH4 level has a predictive value on ACR (95%CI 0.686-0.841, sensitivity 69.1%, specificity 73%). Moreover, in diabetes patients with eGFR 90 ml/min, plasma BH4 level (P = 0.008) is higher than those in diabetes with eGFR<90 ml/min and BH4 was remained independently associated with eGFR after multivariable logistic regression analysis (B = -0.193, P = 0.048). Conclusion: Our established LC-MS/MS method could be used on human plasma BH4 measurements and our data suggested that BH4 level can be used as a biomarker for kidney injury in diabetes indicated by its association with ACR progression and early renal function decline.
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