Purpose: Renal inflammatory response is involved in the development and progression of diabetic kidney disease (DKD). We sought to evaluate pentraxin-3 (PTX3) and adropin variability as inflammatory markers among type 2 diabetes mellitus (T2DM) patients with different urinary albumin, and to examine if these factors assist in the early diagnosis of diabetic kidney disease.
Methods: We enrolled 447 T2DM patients and 100 healthy non-diabetic control subjects in this study. The patients with T2DM were divided into three groups based on their urinary albumin/creatinine ratio (UACR): the normoalbuminuric group (DM group, UACR < 30 mg/g); the microalbuminuric group (DKD1 group, 30 ≤ UACR ≤ 300 mg/g); the macroalbuminuric group (DKD2 group, UACR > 300 mg/g). The levels of PTX3 and adropin were determined by enzyme-linked immunosorbent assay (ELISA). Spearman correlation and multiple linear regression analysis were performed to determine the correlations among these inflammatory markers and other clinical parameters. Receiver operating characteristic (ROC) curves analysis was used to assess the diagnostic potential of PTX3 and adropin for DKD.
Results: Compared to non-diabetes, serum levels of PTX3 were distinctly elevated, whereas the adropin were significantly declined in diabetic patients (p < 0.05). Significantly higher levels of PTX3 and lower levels of adropin were seen in the macroalbuminuric patients compared with the microalbuminuric patients (p < 0.05). Multiple stepwise linear regression analysis showed that the control of hemoglobin A1c (HbA1c) and UACR were independent factors associated with PTX3 and adropin. In addition, ROC curves analysis showed PTX3 and adropin could be used to evaluate the early detect of DKD, further adropin might be a better marker than PTX3 in compliance with their veracity.
Conclusion: As inflammatory markers, the diverse changes of pentraxin-3 and adropin showed that they may forecast the renal damage in diabetic patients in varying degrees and link with the pathogenesis of diabetic kidney disease.
Keywords: Adropin; Diabetes; Inflammatory markers; Pentraxin-3; Renal damage.