Serum Total Sialic Acid and Highly Sensitive C-reactive Protein: Prognostic Markers for the Diabetic Nephropathy

Varma, Vandana; Varma, Meena; Varma, Amit; Kumar, Ravindra; Bharosay, Anuradha; Vyas, Savita

doi:10.4103/0974-2727.176230

Cited by 24 publications

(22 citation statements)

References 21 publications

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“…In line with our results, previous studies also reported high hsCRP in patients with DN. [ 26 27 ] Furthermore, earlier studies reported the utility of some other parameters such as cystatin C, for estimation of eGFR decline, suggesting its high diagnostic accuracy for screening of DN. [ 28 ]…”

Section: Discussionmentioning

confidence: 99%

Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes

2018

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Background:Since the increase in some tubular damage biomarkers can be observed at the early stage of diabetic nephropathy, even in the absence of albuminuria, we aimed to investigate if urinary albumin is superior than tubular damage marker, such as serum retinol-binding protein 4 (RBP4), in predicting renal function decline (defined as estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2) in the cohort of patients with type 2 diabetes mellitus (T2D).Materials and Methods:A total of 106 sedentary T2D patients (mean [± standard deviation] age 64.9 [±6.6] years) were included in this cross-sectional study. Anthropometric and biochemical parameters (fasting glucose, glycated hemoglobin [HbA1c], lipid parameters, creatinine, RBP4, high sensitivity C-reactive protein [hsCRP], urinary albumin excretion [UAE]), as well as blood pressure were obtained.Results:HsCRP (odds ratio [OR] =0.754, 95% confidence interval [CI] (0.603–0.942), P = 0.013) and RBP4 (OR = 0.873, 95% CI [0.824–0.926], P < 0.001) were independent predictors of eGFR decline. Moreover, although RBP4 and UAE as single diagnostic parameters of renal impairment showed excellent clinical accuracy (area under the curve [AUC] = 0.900 and AUC = 0.940, respectively), the Model which included body mass index, HbA1c, triglycerides, hsCRP, and RBP4 showed statistically same accuracy as UAE, when UAE was used as a single parameter (AUC = 0.932 vs. AUC = 0.940, respectively; P for AUC difference = 0.759). As well, the Model had higher sensitivity and specificity (92% and 90%, respectively) than single predictors, RBP4, and UAE.Conclusion:Although serum RBP4 showed excellent clinical accuracy, just like UAE, a combination of markers of tubular damage, inflammation, and traditional markers has the higher sensitivity and specificity than UAE alone for prediction renal impairment in patients with T2D.

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Section: Discussionmentioning

confidence: 99%

Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes

2018

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“…Recently, Liu et al, [18] confirmed that the levels of hs-CRP are higher in macro-albumiuria than micro-albumiuria and normo-albuminuia groups, and it could be used as an indicator of progression of diabetic nephropathy in diabetes mellitus patients. Moreover, Varma et al, [19] reported that hs-CRP levels were significantly correlated to the fasting blood glucose, two hours post prandial, HbA 1C and urinary microalbuminuria. And they stated that it may increase the microangiopathic complications of diabetes mellitus.…”

Section: Discussionmentioning

confidence: 98%

The Association between Highly Sensitive C-Reactive Protein and Interleukin-18 with Nephropathy in a Sample of Type 1 Diabetic Egyptian Patients

Mahmoud¹,

Taha²,

Mohammed

2019

The Medical Journal of Cairo University

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Background: Diabetic Nephropathy (DN) is a major complication of diabetes and the leading cause of end-stage renal disease that accounts for a large proportion of the excess mortality associated with Type-1 Diabetes (T1D). Inflammation and endothelial dysfunction have been hypothesized to play a role in the pathogenesis of DN. Highly sensitivity C-Reactive Protein (hs-CRP) and Interleukin-18 (IL-18) are associated with systemic inflammation and have been shown to be increased in individuals with Type 1 Diabetic nephropathy. Aim of Study: In our study, we aim to determine the association between hs-CRP and IL-18 with nephropathy in a sample of type 1 diabetic Egyptian patients. Patients and Methods: This study was conducted on 30 type-1 diabetic patients (Group I), who subdivided into three subgroups according to their urine Albumin Excretion Rate (AER); Group IA: 10 patients with AER <20 µ g/min, Group IB: 10 patients with AER ranges from 20-200 µ g/min. Group IC: 10 patients with AER is >200 µ g/min and 10 healthy subjects as a control (Group II). Patients and control were subjected to full history taking, full clinical examination, Fasting Plasma Glucose (FPG), Glycated Hemoglobin (HbA 1 c %), serum creatinine, Urinary Albumin Excretion (UAE), Highly-sensitive C-Reactive Protein (hs-CRP) by turbidimetry technique and Interleukin-18 (IL-18) by Enzymelinked Immunosorbent Assay (ELIZA) technique. This work was done during the year 2017. Results: There were statistically significant difference between control group and diabetic group regarding hs-CRP (4.25 ±6.62, 25.13 ± 23.56), and IL-18 (2.85 ±0.74, 12.68± 29.12) with (p=0.009, p=0.037) respectively. In diabetic group, we found a positive significant correlation (p<0.001, p=0.012) between UAE and both; levels of hs-CRP (r=0.765), and IL-18 (r=0.453), respectively. Conclusion: Hs-CRP and IL-18 are sensitive markers for diabetic nephropathy in type-1 diabetic patients.

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“…Hs-CRP is an acute-phase index of micro-inflammatory response that can activate the complement system in the body and enhance the leukocyte phagocytosis by binding to the chromatin and can play a regulatory role by stimulating cell activation ( 16 ). Hs-CRP can cause inflammatory response of the body, which is an important pathological process of DN ( 17 ). Previous findings have shown that hs-CRP is an independent risk factor of obesity and type 2 diabetes and hs-CRP is closely related to DN ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

AMPKα, hs-CRP and FcγR in diabetic nephropathy and drug intervention

et al. 2018

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The aim of this study was to investigate the roles of AMP-activated protein kinase α subunit (AMPKα), hypersensitive C-reactive protein (hs-CRP) and Fcγ receptor (FcγR) in diabetic nephropathy and drug intervention effects. Sixty Sprague Dawley male rats were randomly divided into the control (n=30) and observation (n=30) groups. The model of type 2 diabetic nephropathy was established by high-fat and high-glucose diet and streptozotocin injection. The rats in the observation group were treated with baicalein and the rats in control group did not receive any drug intervention. The pathological changes of kidneys were observed by hematoxylin and eosin (H&E) staining. The expression of AMPKα mRNA in renal tissue was detected by reverse transcription-polymerase chain reaction (RT-PCR). The levels of hs-CRP and FcγR were measured by enzyme-linked immunosorbent assay (ELISA) at 1, 4, 6 and 8 weeks after drug intervention and blood urea nitrogen (BUN) and the 24 h urinary micro-albumin (U-ALB) levels were compared at 1, 4, 6 and 8 weeks after intervention. After 8 weeks of drug intervention, the pathological changes of kidneys in the observation group were significantly lower than those in the control group (p<0.05), while the relative expression levels of AMPKα mRNA and protein in the control group were higher than those in the observation group (p<0.05). The levels of hs-CRP, BUN and 24 h U-ALB in the control group were significantly higher than those in the observation group at different time-points after drug intervention and the level of FcγR in the control group was significantly lower than that in the observation group (p<0.05). Baicalein may protect renal function by inhibiting the expression of AMPKα and inflammatory reaction, and can also decrease BUN and 24 h U-ALB levels and improve the pathological changes of the kidney.

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Serum Total Sialic Acid and Highly Sensitive C-reactive Protein: Prognostic Markers for the Diabetic Nephropathy

Cited by 24 publications

References 21 publications

Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes

Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes

The Association between Highly Sensitive C-Reactive Protein and Interleukin-18 with Nephropathy in a Sample of Type 1 Diabetic Egyptian Patients

AMPKα, hs-CRP and FcγR in diabetic nephropathy and drug intervention

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