Key result
Properly controlled diabetic patients had larger urinary extracellular vesicles than poorly controlled patients (115 vs 109 nm; p<0.05), and renal failure was associated with reduced EV density.
Observational
Absolute Event Rate: 115% vs 109%
p-value: p=<0.05
Density and size of urinary extracellular vesicles reflect deteriorated renal function and may serve as potential biomarkers for renal damage in type 2 diabetes.
Urinary EV size/density may track glycemic control and renal status in diabetes; hypothesis-generating for biomarkers, needs validation.
The aim of this study was to check the relationship between the density of urinary EVs, their size distribution, and the progress of early renal damage in type 2 diabetic patients (DMt2). Patients were enrolled to this study, and glycated hemoglobin (HbA1c) below 7% was a threshold for properly controlled diabetic patients (CD) and poorly controlled diabetic patients (UD). Patients were further divided into two groups: diabetic patients without renal failure (NRF) and with renal failure (RF) according to the Glomerular Filtration Rate. Density and diameter of EVs were determined by Tunable Resistive Pulse Sensing. Additionally, EVs were visualized by means of Transmission and Environmental Scanning Electron Microscopy. Nano-liquid chromatography coupled offline with mass spectrometry (MALDI-TOF-MS/MS) was applied for proteomic analysis. RF had reduced density of EVs compared to NRF. The size distribution study showed that CD had larger EVs (mode) than UD (115 versus 109 nm;p<0.05); nevertheless the mean EVs diameter was smaller in controls than in the CD group (123 versus 134 nm;p<0.05). It was demonstrated that EVs are abundant in urine. Albumin, uromodulin, and number of unique proteins related to cell stress and secretion were detected in the EVs fraction. Density and size of urinary EVs reflect deteriorated renal function and can be considered as potential renal damage biomarkers.
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Kamińska et al. (2016) conducted an observational in Type 2 diabetes. Glycemic control and renal failure status vs. Poorly controlled diabetes / no renal failure / healthy controls was evaluated on Urinary extracellular vesicle size (mode) (p=<0.05). Properly controlled diabetic patients had larger urinary extracellular vesicles than poorly controlled patients (115 vs 109 nm; p<0.05), and renal failure was associated with reduced EV density.
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