Key result
Elevated urinary ANGPTL-4 linked to ~3.4-fold higher diabetic kidney disease prevalence in T2D.
Why the study?
The study was designed to evaluate urinary levels of KIM-1 and ANGPTL-4 in individuals with diabetic kidney disease and their association with established markers including albuminuria and eGFR.
Do urinary levels of ANGPTL-4 and KIM-1 accurately diagnose diabetic kidney disease in patients with type 2 diabetes?
Cross-Sectional (n=135)
No
Do urinary levels of ANGPTL-4 and KIM-1 accurately diagnose diabetic kidney disease in patients with type 2 diabetes?
Effect estimate: PR 3.40 (95% CI 2.32 to 4.98)
p-value: p=<0.001
Urinary ANGPTL-4 and KIM-1 show high diagnostic potential as biomarkers for diabetic kidney disease in patients with type 2 diabetes.
Urinary ANGPTL-4 and KIM-1 were associated with DKD prevalence; leaves open their diagnostic role pending prospective validation in type 2 diabetes.
The purpose of the study was to examine the urinary levels of kidney injury molecule-1 (KIM-1) and angiopoietin-like protein-4 (ANGPTL-4) in individuals with diabetic kidney disease (DKD) and their association with established DKD diagnostic markers such as albuminuria and estimated glomerular filtration rate (eGFR). Levels of ANGPTL-4 and KIM-1 were estimated in urine samples. A total of 135 participants were recruited into three groups: 45 diabetes type 2 patients in the control group and 90 DKD patients in two disease groups. Concentrations of ANGPTL-4 and KIM-1 were conclusively related to the urinary albumin–creatinine ratio (UACR). Also, the levels of both ANGPTL-4 and KIM-1 were negatively associated with the eGFR. Multivariable Poisson regression analysis showed that urinary ANGPTL-4 (PR: 3.40; 95% CI: 2.32 to 4.98; p < 0.001) and KIM-1 (PR: 1.25; 95% CI: 1.14 to 1.38; p < 0.001) were prevalent in DKD patients. Receiver operating characteristic (ROC) analysis of urinary ANGPTL-4 and KIM-1 in the combined form resulted in an area under curve (AUC) of 0.967 (95%CI: 0.932–1.000; p < 0.0001) in the microalbuminuria group and 1 (95%CI: 1.000–1.000; p < 0.0001) in the macroalbuminuria group. The association of urinary levels of ANGPTL-4 and KIM-1 with UACR and eGFR and significant prevalence in the diabetic kidney disease population illustrates the diagnostic potential of these biomarkers.
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Bano et al. (2023) conducted a cross-sectional in Diabetic Kidney Disease (n=135). Urinary ANGPTL-4 and KIM-1 levels vs. Normoalbuminuria (type 2 diabetes without kidney disease) was evaluated on Prevalence of diabetic kidney disease (PR 3.40, 95% CI 2.32 to 4.98, p=<0.001). Elevated urinary levels of ANGPTL-4 and KIM-1 were significantly associated with an increased prevalence of diabetic kidney disease (PR 3.40 and 1.25, respectively) in patients with type 2 diabetes.
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