期刊
PEDIATRIC NEPHROLOGY
卷 37, 期 12, 页码 3085-3092出版社
SPRINGER
DOI: 10.1007/s00467-022-05487-4
关键词
Biomarkers; Tubular injury; Diabetic kidney disease; Pediatrics; YKL-40; KIM-1
资金
- NIH/NIDDK [K23-DK116720, UH3 DK114866, U01 DK106962, R01 DK093770]
- JDRF [2-SRA2018-627-M-B, 3-SRA2022-1097-M-B, 2-SRA-2019-845-S-B, 3-SRA-2017-424-M-B]
- NIH/NHLBI [K23 HL159292, R01 HL085757]
- Children's Hospital Colorado Research Scholar Award
- University of Colorado Diabetes Research Center [P30 DK116073]
- Ludeman Family Center for Women's Health Research at the University of Colorado
- Department of Pediatrics, Section of Endocrinology at the University of Colorado School of Medicine
- Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases
- NIDDK [P30 DK116073, R01 DK129211, R21 DK129720, K23 DK116720, UC DK114886]
- Boettcher Foundation
- American Heart Association [20IPA35260142]
- Department of Pediatrics, Section of Endocrinology
- Barbara Davis Center for Diabetes at University of Colorado School of Medicine
This study examined the relationship between kidney biomarkers and intrarenal hemodynamic function in adolescents with type 1 diabetes (T1D). The results showed that higher concentrations of biomarkers YKL-40 and KIM-1 were associated with higher glomerular filtration rate (GFR), renal plasma flow (RPF), and intraglomerular pressure (P-GLO) in adolescents with T1D. The study suggests that elevated concentrations of YKL-40 and KIM-1 may help define the risk for intraglomerular hemodynamic dysfunction in youth with T1D.
Background Early identification of youth with type 1 diabetes (T1D) at risk for diabetic kidney disease may improve clinical outcomes. We examined the cross-sectional relationship between kidney biomarkers neutrophil gelatinase-associated lipocalin (NGAL), copeptin, interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1), chitinase-3-like protein-1 (YKL-40), and monocyte chemoattractant protein-1 (MCP-1) and intrarenal hemodynamic function in adolescents with T1D. Methods Urine albumin-to-creatinine ratio (UACR), renal vascular resistance (RVR), glomerular filtration rate (GFR), intraglomerular pressure (P-GLO), efferent arteriole resistance (R-E), afferent arteriolar resistance (R-A), and renal plasma flow (RPF), and the above indicated biomarkers were assessed in youth aged 12-21 years with and without T1D of < 10 years duration. Results Fifty adolescents with T1D (16.1 +/- 3.0 years, HbA1c 8.6 +/- 1.2%) and 20 adolescents of comparable BMI without T1D (16.1 +/- 2.9 years, HbA1c 5.2 +/- 0.2%) were enrolled. Adolescents with T1D demonstrated significantly higher GFR, RPF, R-E, and P-GLO than controls (39%, 33%, 74%, and 29%, respectively, all p < 0.0001). Adolescents with T1D also exhibited significantly lower RVR and R-A than controls (25% and 155%, respectively, both p < 0.0001). YKL-40 and KIM-1 concentrations, respectively, were positively associated with GFR (r: 0.43, p = 0.002; r: 0.41, p = 0.003), RPF (r: 0.29, p = 0.08; r: 0.34, p = 0.04), UACR (r: 0.33, p = 0.02; r: 0.50, p = 0.0002), and P-GLO (r: 0.45, p = 0.006; r: 0.52, p = 0.001) in adolescents with T1D. Conclusions Higher concentrations of biomarkers YKL-40 and KIM-1 may help define the risk for intraglomerular hemodynamic dysfunction in youth with T1D.
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