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Periostin as a tissue and urinary biomarker of renal injury in type 2 diabetes mellitus.

Satirapoj B, Tassanasorn S, Charoenpitakchai M, Supasyndh O - PLoS ONE (2015)

Bottom Line: Improving the early detection of diabetic nephropathy remains a great challenge in disease management.Urine samples were obtained from 30 healthy volunteers and 328 type 2 diabetic patients with normoalbuminuria (n=114), microalbuminuria (n=100) and macroalbuminuria (n=114).The excretion levels of urinary periostin were quantified with enzyme-linked immunosorbent assay.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.

ABSTRACT

Background: Improving the early detection of diabetic nephropathy remains a great challenge in disease management. Periostin is a marker of renal tubular injury and related to progressive kidney injury in animal models of chronic kidney disease. The clinical implications of urinary periostin activities in patients with type 2 diabetes have not been evaluated.

Methods: Urine samples were obtained from 30 healthy volunteers and 328 type 2 diabetic patients with normoalbuminuria (n=114), microalbuminuria (n=100) and macroalbuminuria (n=114). The excretion levels of urinary periostin were quantified with enzyme-linked immunosorbent assay. Immunohistochemical periostin expression was determined in kidney tissues from overt diabetic nephropathy.

Results: Increased periostin expression in glomeruli and tubular epithelium in diabetic renal pathology was observed. Urinary periostin levels were significantly elevated in the patients of the normoalbuminuria [3.06 (IQR: 1.12, 6.77) ng/mgCr], microalbuminuria [8.71 (IQR: 5.09, 19.29) ng/mgCr] and macroalbuminuria [13.58 (IQR: 3.99, 16.19) ng/mgCr] compared with healthy controls [1.15 (IQR: 0.60, 1.63) ng/mgCr] (P<0.01).Increased urine periostin level significantly correlated with aging, high albuminuria and decline of GFR. Urine periostin ELISA also demonstrated high performance for the diagnosis of established normoalbuminuric, microalbuminuric and macroalbuminuric type 2 diabetes (AUC 0.78 (95%CI, 0.71 to 0.86), 0.99 (95%CI, 0.98 to 1.00) and 0.95 (95%CI, 0.91 to 0.98), respectively).

Conclusion: The study indicates that increased urine periostin levels can be detected in patients with type 2 diabetes before the onset of significant albuminuria. Urinary periostin is an associated renal derangement in patients with established diabetic nephropathy and it may be used as an early marker of diabetic renal injury.

No MeSH data available.


Related in: MedlinePlus

Urine periostin levels in patients with diabetic nephropathy and in healthy controls.Significant differences were observed between the urine periostin values in the each stage of diabetic nephropathy (P<0.001) compared with healthy subjects. Data are presented as the median with interquartile range. Open and filled circles were defined as outlier data more than 1.5 times of upper quartile.
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pone.0124055.g002: Urine periostin levels in patients with diabetic nephropathy and in healthy controls.Significant differences were observed between the urine periostin values in the each stage of diabetic nephropathy (P<0.001) compared with healthy subjects. Data are presented as the median with interquartile range. Open and filled circles were defined as outlier data more than 1.5 times of upper quartile.

Mentions: Fig 2 shows the urinary periostin levels in healthy volunteers and patients with type 2 diabetes. Urine periostin was measured by ELISA and corrected for urine creatinine. Median urine periostin levels in healthy controls [1.15 (IQR: 0.60, 1.63) ng/mgCr] was significantly less than in patients with normoalbuminuric type 2 diabetes [3.06 (IQR: 1.12, 6.77) ng/mgCr, p<0.001], microalbuminuric type 2 diabetes [8.71 (IQR: 5.09, 19.29) ng/mgCr, p<0.001] and macroalbuminuric type 2 diabetes [13.58 (IQR: 3.99, 16.19) ng/mgCr, p<0.001] (Fig 2)(S1 Dataset). In addition, significant differences were found between the urine periostin values in normoalbuminuric type 2 diabetes and other stages of diabetic nephropathy. The appearance of urine periostin in type 2 diabetes patients but not in healthy controls underscores its value as a potential biomarker for kidney injury in albuminuric and nonalbuminuric type 2 diabetes.


Periostin as a tissue and urinary biomarker of renal injury in type 2 diabetes mellitus.

Satirapoj B, Tassanasorn S, Charoenpitakchai M, Supasyndh O - PLoS ONE (2015)

Urine periostin levels in patients with diabetic nephropathy and in healthy controls.Significant differences were observed between the urine periostin values in the each stage of diabetic nephropathy (P<0.001) compared with healthy subjects. Data are presented as the median with interquartile range. Open and filled circles were defined as outlier data more than 1.5 times of upper quartile.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401767&req=5

pone.0124055.g002: Urine periostin levels in patients with diabetic nephropathy and in healthy controls.Significant differences were observed between the urine periostin values in the each stage of diabetic nephropathy (P<0.001) compared with healthy subjects. Data are presented as the median with interquartile range. Open and filled circles were defined as outlier data more than 1.5 times of upper quartile.
Mentions: Fig 2 shows the urinary periostin levels in healthy volunteers and patients with type 2 diabetes. Urine periostin was measured by ELISA and corrected for urine creatinine. Median urine periostin levels in healthy controls [1.15 (IQR: 0.60, 1.63) ng/mgCr] was significantly less than in patients with normoalbuminuric type 2 diabetes [3.06 (IQR: 1.12, 6.77) ng/mgCr, p<0.001], microalbuminuric type 2 diabetes [8.71 (IQR: 5.09, 19.29) ng/mgCr, p<0.001] and macroalbuminuric type 2 diabetes [13.58 (IQR: 3.99, 16.19) ng/mgCr, p<0.001] (Fig 2)(S1 Dataset). In addition, significant differences were found between the urine periostin values in normoalbuminuric type 2 diabetes and other stages of diabetic nephropathy. The appearance of urine periostin in type 2 diabetes patients but not in healthy controls underscores its value as a potential biomarker for kidney injury in albuminuric and nonalbuminuric type 2 diabetes.

Bottom Line: Improving the early detection of diabetic nephropathy remains a great challenge in disease management.Urine samples were obtained from 30 healthy volunteers and 328 type 2 diabetic patients with normoalbuminuria (n=114), microalbuminuria (n=100) and macroalbuminuria (n=114).The excretion levels of urinary periostin were quantified with enzyme-linked immunosorbent assay.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.

ABSTRACT

Background: Improving the early detection of diabetic nephropathy remains a great challenge in disease management. Periostin is a marker of renal tubular injury and related to progressive kidney injury in animal models of chronic kidney disease. The clinical implications of urinary periostin activities in patients with type 2 diabetes have not been evaluated.

Methods: Urine samples were obtained from 30 healthy volunteers and 328 type 2 diabetic patients with normoalbuminuria (n=114), microalbuminuria (n=100) and macroalbuminuria (n=114). The excretion levels of urinary periostin were quantified with enzyme-linked immunosorbent assay. Immunohistochemical periostin expression was determined in kidney tissues from overt diabetic nephropathy.

Results: Increased periostin expression in glomeruli and tubular epithelium in diabetic renal pathology was observed. Urinary periostin levels were significantly elevated in the patients of the normoalbuminuria [3.06 (IQR: 1.12, 6.77) ng/mgCr], microalbuminuria [8.71 (IQR: 5.09, 19.29) ng/mgCr] and macroalbuminuria [13.58 (IQR: 3.99, 16.19) ng/mgCr] compared with healthy controls [1.15 (IQR: 0.60, 1.63) ng/mgCr] (P<0.01).Increased urine periostin level significantly correlated with aging, high albuminuria and decline of GFR. Urine periostin ELISA also demonstrated high performance for the diagnosis of established normoalbuminuric, microalbuminuric and macroalbuminuric type 2 diabetes (AUC 0.78 (95%CI, 0.71 to 0.86), 0.99 (95%CI, 0.98 to 1.00) and 0.95 (95%CI, 0.91 to 0.98), respectively).

Conclusion: The study indicates that increased urine periostin levels can be detected in patients with type 2 diabetes before the onset of significant albuminuria. Urinary periostin is an associated renal derangement in patients with established diabetic nephropathy and it may be used as an early marker of diabetic renal injury.

No MeSH data available.


Related in: MedlinePlus