Value of urinary adiponectin, VCAM-1 and RBP 4 in early diagnosis of kidney damage in children with type 1 diabetes mellitus
Keywords:diabetes mellitus, diabetic nephropathy, children, biomarkers, adiponectin, VCAM-1, RBP 4
Aim. The aim of the current study was to investigate urinary adiponectin, VCAM-1, and RBP 4 levels in children depending on the diabetes duration.
Materials and methods. The study involved 55 subjects, including 47 children with type 1 diabetes mellitus and eight children without diabetes and kidney disease history. Participants with diabetes were stratified into three groups, depending on the diabetes duration: <1 year (11 people), 1–5 years (24 people) and >5 years (12 people). According to the Order of the Ministry of Health of Ukraine, dated April 27, 2006, No. 254 on providing medical care to children in the specialty “Pediatric Endocrinology”, we examined the children and diagnosed type 1 diabetes mellitus. Chemiluminescence signals of adiponectin, VCAM-1, and RBP4 in urine were analyzed with Bio-Rad ChemiDoc Touch using a Proteome Profiler Human Kidney Biomarker Antibody Array (R&D Systems, Minneapolis, USA). We used descriptive statistics and nonparametric methods (contingency tables and Spearman’s rank correlation coefficient (r)) for the statistical analysis of study materials. Statistically significant differences were indicated by P values <0.05.
Results. Urinary adiponectin, VCAM-1, and RBP 4 levels statistically increased within the first year after diagnosing type 1 diabetes in children. Adiponectin was strongly correlated with VCAM-1 (r = 0.636, P = 0.026), and RBP 4 (r = 0.650, P = 0.022). Urinary adiponectin levels showed a statistically significant correlation with GFR (r = 0.007).
Conclusions. Serum creatinine and GFR are ineffective as diagnostic indicators of kidney damage in children with diabetes mellitus at the incipient stages. Adiponectin in children’s urine can be used as a non-invasive kidney damage marker in the early years of type 1 diabetes. Adiponectin, VCAM-1, and RBP 4 measurements would allow an early prediction and evaluation of both tubular and glomerular kidney damage in children with diabetes.
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