Urine Proteome Specific for Eye Damage Can Predict Kidney Damage in Patients With Type 2 Diabetes: A Case-Control and a 5.3-Year Prospective Cohort Study

Jy, Yang; Wang, Yingying; Liu, Chang; Shi, Tingting; Lü, Jing; Cao, Xi; Yang, Fengying; Feng, Jiafu; Chen, Chen; Ji, Linong; Xu, Aimin

doi:10.2337/dc16-1529

Cited by 36 publications

(43 citation statements)

References 32 publications

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“…In an interesting recent contribution, Yang et al . found urinary proteins specific for proliferative diabetic retinopathy in a cohort of 210 patients with type 2 diabetes.…”

Section: Urinary Proteomicsmentioning

confidence: 99%

Urinary Proteomics and Precision Medicine for Chronic Kidney Disease: Current Status and Future Perspectives

Persson

Rossing

2019

Proteomics Clinical Apps

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Precision medicine is since long an ongoing refinement of classical medicine, integrating improved and more detailed pathophysiological understanding with rapid technological advances. In the heterogenous area of chronic kidney disease there seems to be a high potential for the improvement in treatment and prognosis for several causes, with new technologies under development, that are yet to be introduced in clinical practice. As in other medical disciplines, investigation of abundant peptide patterns (proteomics) has gained recent interest. Especially relevant for kidney disease, urinary proteomics may provide both improved diagnosis and, as reviewed here, also holds promise for personalized treatment in the future. So far, capillary electrophoresis coupled to mass spectrometry (CE-MS) is the most widely applied technique, and in addition to several cross-sectional and cohort studies, there is even an ongoing randomized controlled trial that will soon report on the concept used as a method of personalizing treatment. In addition, there is hope that urinary proteomics can turn into a "liquid biopsy," replacing the invasive diagnostic procedure. The next couple of years will provide more answers on the topic.

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“…In an interesting recent contribution, Yang et al . found urinary proteins specific for proliferative diabetic retinopathy in a cohort of 210 patients with type 2 diabetes.…”

Section: Urinary Proteomicsmentioning

confidence: 99%

Urinary Proteomics and Precision Medicine for Chronic Kidney Disease: Current Status and Future Perspectives

Persson

Rossing

2019

Proteomics Clinical Apps

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“…Some studies have shown that the gene 677C/T polymorphism might be related to an increased risk of DN and DR. 15 Some scholars think that there are similar molecular pathways leading to damage to the diabetic kidney and retinal microvasculature, 16,17 and oxidative stress plays an important role in this process. 18 This study aims to build a convenient and practical prediction model to evaluate the risk of DN or DR in T2DM patients. At present, most literature related to T2DM is related to factors of DN or DR. To avoid neglecting the potential relationship between DN and DR and improve the reliability of the results, this study first screened the risk factors for DN and DR, and patients with both DN and DR were further tested.…”

Section: Introductionmentioning

confidence: 99%

<p>Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study</p>

Shi¹,

Niu²,

Wu³

et al. 2020

DMSO

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Purpose: This study aimed to develop a diabetic nephropathy (DN) or diabetic retinopathy (DR) incidence risk nomogram in China's population with type 2 diabetes mellitus (T2DM) based on a community-based sample. Methods: We carried out questionnaire evaluations, physical examinations and biochemical tests among 4219 T2DM patients in Shanghai. According to the incidence of DN and DR, 4219 patients in our study were divided into groups of T2DM patients with DN or DR, patients with both, and patients without any complications. We successively used least absolute shrinkage and selection operator regression analysis and logistic regression analysis to optimize the feature selection for DN and DR. To ensure the accuracy of the results, we carried out multivariable logistic regression analysis of the above significant risk factors on the sample data for both DN and DR. The selected features were included to establish a prediction model. The C-index, calibration plot, curve analysis and internal validation were used to validate the distinction, calibration, and clinical practicality of the model. Results: The predictors in the prediction model included disease course, body mass index (BMI), total triglycerides (TGs), systolic blood pressure (SBP), postprandial blood glucose (PBG), haemoglobin A1C (HbA1c) and blood urea nitrogen (BUN). The model displayed moderate predictive power with a C-index of 0.807 and an area under the receiver operating characteristic curve of 0.807. In internal verification, the C-index reached 0.804. The risk threshold was 16-75% according to the analysis of the decision curve, and the nomogram could be applied in clinical practice. Conclusion: This DN or DR incidence risk nomogram incorporating disease course, BMI, TGs, SBP, PBG, HbA1c and BUN can be used to predict DN or DR incidence risk in T2DM patients. The research team has developed an online app based on a clinical prediction model incorporating risk factors for rapid and simple prediction.

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“…A 5.3-year prospective cohort study, performed by Yang' group [24], found that the risk of renal insufficiency is higher if the baseline urinary Hp is equal or larger than 20 ng/min in T2DM patients. However, previous studies [11,22,24] didn't investigate the relationship between urine Hp and renal tubular damage. Hence, we further confirmed the correlation between UHCR and tubular injury biomarkers.…”

Section: Discussionmentioning

confidence: 99%

Urine Haptoglobin/Creatinine Ratio Correlates with Tubular Injury Biomarkers and Severity of Albuminuria in Type 2 Diabetes Patients

et al. 2019

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This aim of this study was to investigate the correlation between urine haptoglobin/creatinine ratio(UHCR) and tubular injury biomarkers or severity of albuminuria in type 2 diabetes. Recruited T2DM patients (n=120) were divided into three groups based on urine albumin/creatinine ratio (UACR): normal albuminuria (Normo group, UACR<30 mg/g, n=40), microalbuminuria (Micro group, 30 mg/g ≤UACR<300 mg/g, n=38), and macroalbuminuria (Macro group, UACR ≥300 mg/g, n=42), with matched healthy individuals (NC group, n=30) as controls. ELISA assay was used to detect the levels of urine haptoglobin, NGAL and KIM-1. Automated biochemical analyzer was applied to detect the concentrations of urine creatinine and retinol binding protein (RBP). To eliminate concentration errors, urine NGAL, KIM-1, and RBP were normalized by creatinine and expressed as UHCR, UNCR, UKCR, and URCR, respectively. We found UHCR was significantly increased in T2DM patients as compared with NC group. Among the three diabetic groups, the Macro group had the highest level of UHCR, whereas the Normo group had the lowest level. T2DM patients with higher UHCR levels also had higher levels of UNCR, UKCR, and URCR. Spearman’s correlation analysis indicated that UHCR was positively correlated with UACR, UNCR, UKCR, or URCR levels, and negatively correlated with eGFR. ROC curve analysis showed that UHCR was a sensitive and specific indicator for early diagnosis of DN. Stepwise multiple regression analysis showed that UHCR and UNCR were independent variables for UACR. Our research demonstrated that UHCR correlates with tubular injury biomarkers, including UNCR, UKCR, and URCR, and is independently associated with the severity of albuminuria in T2DM.

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Urine Proteome Specific for Eye Damage Can Predict Kidney Damage in Patients With Type 2 Diabetes: A Case-Control and a 5.3-Year Prospective Cohort Study

Abstract: Urine haptoglobin, which is specific for PDR, is a novel biomarker and complement to urine albumin for predicting kidney damage in patients with T2D.

Cited by 36 publications

References 32 publications

Urinary Proteomics and Precision Medicine for Chronic Kidney Disease: Current Status and Future Perspectives

Urinary Proteomics and Precision Medicine for Chronic Kidney Disease: Current Status and Future Perspectives

<p>Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study</p>

Urine Haptoglobin/Creatinine Ratio Correlates with Tubular Injury Biomarkers and Severity of Albuminuria in Type 2 Diabetes Patients

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