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Progranulin has been recognized as an adipokine related to obesity, insulin resistance and type 2 diabetes mellitus T2DM. There are scarce data regarding progranulin and kidney disease, but there are some data linking diabetic kidney disease DKD and increased progranulin levels. We aimed to better describe the relationship between serum and urinary progranulin levels and DKD in T2DM. This is a case-control study including four groups of subjects: 1 Advanced DKD cases: T2DM patients with estimated glomerular filtration rate eGFR <60 mL-min-1.73m2; 2 Albuminuric DKD cases: T2DM patients with urinary albumin excretion UAE ≥30 mg-g creatinine and eGFR ≥60 mL-min-1.73m2; 3 Diabetic controls: T2DM patients with UAE <30 mg-g creatinine and eGFR ≥60 mL-min-1.73m2; and 4 Non-diabetic controls: individuals without T2DM. Progranulin was determined by enzyme-linked immunosorbent assay. One hundred and fourteen patients were included 23 advanced DKD cases, 25 albuminuric DKD cases, 40 diabetic controls and 26 non-diabetic controls. Serum progranulin was increased in advanced DKD compared to other groups 70.84 59.04–83.16 vs. albuminuric cases 57.16 42.24–67.38, diabetic controls 57.28 42.08–70.47 and non-diabetic controls 44.54 41.44–53.32 ng-mL; p<0.001. Urinary progranulin was decreased in advanced DKD cases compared to albuminuric cases 10.62 6.30–16.08 vs. 20.94 12.35–30.22; diabetic controls 14.06 9.88–20.82 and non-diabetic controls 13.51 7.94–24.36 ng-mL; p = 0.017. There was a positive correlation between serum progranulin and body mass index r = 0.27; p = 0.004, waist circumference r = 0.25; p = 0.007; body fat percentage r = 0.20; p = 0.042, high-sensitive C reactive protein r = 0.35; p<0.001 and interleukin-6 r = 0.37; p<0.001 and a negative correlation with eGFR r = -0.22; p = 0.023. Urinary progranulin was positively associated with albuminuria r = 0.25; p = 0.010. In conclusion, progranulin is affected by a decrease in eGFR, being at a higher concentration in serum and lower in urine of DKD patients with T2DM and eGFR <60 mL-min-1.73m2. It is also associated with markers of obesity and inflammation.



Autor: Bruna Bellincanta Nicoletto , Thaiana Cirino Krolikowski, Daisy Crispim, Luis Henrique Canani

Fuente: http://plos.srce.hr/



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