Four Novel Biomarkers May Predict Diabetic Kidney Damage

Panel of four protein biomarkers may serve as predictors of early renal decline in type 1 diabetes

FRIDAY, Jan. 20 (HealthDay News) -- In patients with type 1 diabetes, a panel of four novel protein biomarkers may predict early kidney damage, according to a study published online Jan. 11 in Diabetes Care.

Daniela Schlatzer, of the Case Western Reserve University in Cleveland, and colleagues investigated novel protein biomarkers of renal disease in participants of the Coronary Artery Calcification in Type 1 Diabetes study. A group of 465 participants, initially free of renal complications, were monitored for development of micro- or macroalbuminuria (MA) and early renal function decline (ERFD). In 13 patients who progressed to MA by six years and 11 controls, a label-free discovery phase was performed. Four proteins identified in this phase (Tamm-Horsfall glycoprotein, progranulin, clusterin, and α-1 acid glycoprotein) were evaluated by enzyme-linked immunosorbent assay in 35 subjects with normal renal function, 15 EFRD patients without MA, 16 with MA but not EFRD, and eight with both EFRD and MA.

The researchers found that a model of progression to MA, built using 252 peptides, gave an estimated area under the curve (AUC) of 84.7 percent. In a validation study to predict ERFD, MA, or both, the AUC was improved from 0.841 to 0.889 using a panel of the four biomarkers (Tamm-Horsfall glycoprotein [odds ratio (OR), 2.9; 95 percent confidence interval (CI), 1.3 to 6.2; P = 0.008], progranulin [OR, 1.9; 95 percent CI, 0.8 to 4.5; P = 0.16], clusterin [OR, 0.6; 95 percent CI, 0.3 to 1.1; P = 0.09], and α-1 acid glycoprotein [OR, 1.6; 95 percent CI, 0.7 to 3.7; P =0.27]).

"Further validation of this protein panel is needed in other populations to verify their predictive ability for the development of both renal function decline and urinary albumin and to determine whether these could be used as biomarkers of disease progression and response to treatment," the authors write.

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