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  • Title: Correlation between urine vitamin D-binding protein and early-stage renal damage in Type 2 diabetes.
    Author: Huang Y, Chen S, Dai Q, Zhang H, Liu Y.
    Journal: Zhong Nan Da Xue Xue Bao Yi Xue Ban; 2023 Jan 28; 48(1):40-48. PubMed ID: 36935176.
    Abstract:
    OBJECTIVES: The excretion of urinary vitamin D-binding protein (uVDBP) is related to the occurrence and development of early-stage renal damage in patients with Type 2 diabetes (T2DM). This study aims to explore the significance of detecting uVDBP in T2DM patients and its relationship with renal tubules, and to provide a new direction for the early diagnosis of T2DM renal damage. METHODS: A total of 105 patients with T2DM, who met the inclusion criteria, were included as a patient group, and recruited 30 individuals as a normal control group. The general information and blood and urine biochemical indicators of all subjects were collected; the levels of uVDBP, and a marker of tubular injury [urine kidney injury molecule 1 (uKIM-1), urine neutrophil gelatinase-associated lipocalin (uNGAL) and urine retinol-binding protein (uRBP)] were detected by enzyme-linked immunosorbent assay. The results were corrected by urinary creatinine (Cr) to uVDBP/Cr, uKIM-1/Cr, uNGAL/Cr and uRBP/Cr. The Pearson's and Spearman's correlation tests were used to analyze the correlation between uVDBP/Cr and urine albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR) and markers of tubular injury, and multivariate linear regression and receiver operating characteristic curve were used to analyze the correlation between uVDBP/Cr and UACR or eGFR. RESULTS: Compared with the normal control group, the uVDBP/Cr level in the patient group was increased (P<0.05), and which was positively correlated with UACR (r=0.774, P<0.01), and negatively correlated with eGFR (r=-0.397, P<0.01). There were differences in the levels of uKIM-1/Cr, uNGAL/Cr, and uRBP/Cr between the 2 groups (all P<0.01). The uVDBP/Cr was positively correlated with uKIM-1/Cr (r=0.752, P<0.01), uNGAL/Cr (r=0.644, P<0.01) and uRBP/Cr (r=0.812, P<0.01). The sensitivity was 90.0% and the specificity was 82.9% (UACR>30 mg/g) for evaluation of uVDBP/Cr on T2DM patients with early-stage renal damage, while the sensitivity was 75.0% and the specificity was 72.6% for evaluation of eGFR on T2DM patients with early-stage renal damage. CONCLUSIONS: The uVDBP/Cr can be used as a biomarker in early-stage renal damage in T2DM patients. 目的: 尿维生素D结合蛋白(urine vitamin D-binding protein，uVDBP)的排泄可能参与2型糖尿病(Type 2 diabetic mellitus，T2DM)患者早期肾损害的发生和发展，本研究旨在探讨uVDBP在T2DM患者中的检测意义及其与肾小管的关系，为T2DM肾损害的早期诊断提供新的方向。方法: 纳入符合入组标准的105例T2DM患者(患者组)和同期募集健康体检者30例(正常对照组)，收集所有入组人员的一般资料及血、尿液生物化学指标，并采用ELISA法检测uVDBP、尿人肾损伤因子-1(urine kidney injury molecule 1，uKIM-1)、尿中性粒细胞明胶酶相关脂质运载蛋白(urine neutrophil gelatinase-associated lipocalin，uNGAL)、尿视黄醇结合蛋白(urine retinol-binding protein，uRBP)水平，再经尿肌酐(creatinine，Cr)校正为uVDBP/Cr、uKIM-1/Cr、uNGAL/Cr、uRBP/Cr。采用Pearson和Spearman相关性检验分析uVDBP/Cr与尿白蛋白肌酐比值(urine albumin-to-creatinine ratio，UACR)、肾小球滤过率估计值(estimated glomerular filtration rate，eGFR)及肾小管损伤标志物之间的相关性；采用多重线性回归和受试者操作特征曲线分析uVDBP/Cr与UACR和eGFR的相关性。结果: 与正常对照组相比，患者组的uVDBP/Cr升高(P<0.05)，且与UACR呈正相关(r=0.774，P<0.01)；与eGFR呈负相关(r=-0.397，P<0.01)。两组之间的uKIM-1/Cr、uNGAL/Cr、uRBP/Cr水平差异均有统计学意义(均P<0.01)；uVDBP/Cr与uKIM-1/Cr(r=0.752，P<0.01)、uNGAL/Cr(r=0.644，P<0.01)、uRBP/Cr(r=0.812，P<0.01)均呈正相关。uVDBP/Cr对T2DM早期肾损害患者评估的灵敏度为90.0%，特异度为82.9%；eGFR对T2DM早期肾损害患者评估的灵敏度为75.0%，特异度为72.6%。结论: uVDBP/Cr可以作为早期评估T2DM患者肾损害的生物学标志物。. OBJECTIVE: The excretion of urinary vitamin D-binding protein (uVDBP) is related to the occurrence and development of early-stage renal damage in patients with Type 2 diabetes (T2DM). This study aims to explore the significance of detecting uVDBP in T2DM patients and its relationship with renal tubules, and to provide a new direction for the early diagnosis of T2DM renal damage. METHODS: A total of 105 patients with T2DM, who met the inclusion criteria, were included as a patient group, and recruited 30 individuals as a normal control group. The general information and blood and urine biochemical indicators of all subjects were collected; the levels of uVDBP, and a marker of tubular injury [urine kidney injury molecule 1 (uKIM-1), urine neutrophil gelatinase-associated lipocalin (uNGAL) and urine retinol-binding protein (uRBP)] were detected by enzyme-linked immunosorbent assay. The results were corrected by urinary creatinine (Cr) to uVDBP/Cr, uKIM-1/Cr, uNGAL/Cr and uRBP/Cr. The Pearson’s and Spearman’s correlation tests were used to analyze the correlation between uVDBP/Cr and urine albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR) and markers of tubular injury, and multivariate linear regression and receiver operating characteristic curve were used to analyze the correlation between uVDBP/Cr and UACR or eGFR. RESULTS: Compared with the normal control group, the uVDBP/Cr level in the patient group was increased (P<0.05), and which was positively correlated with UACR (r=0.774, P<0.01), and negatively correlated with eGFR (r=-0.397, P<0.01). There were differences in the levels of uKIM-1/Cr, uNGAL/Cr, and uRBP/Cr between the 2 groups (all P<0.01). The uVDBP/Cr was positively correlated with uKIM-1/Cr (r=0.752, P<0.01), uNGAL/Cr (r=0.644, P<0.01) and uRBP/Cr (r=0.812, P<0.01). The sensitivity was 90.0% and the specificity was 82.9% (UACR>30 mg/g) for evaluation of uVDBP/Cr on T2DM patients with early-stage renal damage, while the sensitivity was 75.0% and the specificity was 72.6% for evaluation of eGFR on T2DM patients with early-stage renal damage. CONCLUSION: The uVDBP/Cr can be used as a biomarker in early-stage renal damage in T2DM patients.
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