Key result
Urinary periostin detects early diabetic renal injury in normoalbuminuric T2D with an AUC of 0.78.
Why the study?
Does urinary periostin serve as an early biomarker of renal injury in patients with type 2 diabetes mellitus?
Cross-Sectional (n=358)
No
Does urinary periostin serve as an early biomarker of renal injury in patients with type 2 diabetes mellitus?
Urinary periostin is significantly elevated in type 2 diabetes patients prior to the onset of microalbuminuria, suggesting its potential utility as an early, non-invasive biomarker for diabetic renal injury.
Answers are grounded in this paper and cite their sources.
May aid early diabetic renal injury detection; cross-sectional data leave clinical adoption unproven.
BACKGROUND: Improving the early detection of diabetic nephropathy remains a great challenge in disease management. Periostin is a marker of renal tubular injury and related to progressive kidney injury in animal models of chronic kidney disease. The clinical implications of urinary periostin activities in patients with type 2 diabetes have not been evaluated. METHODS: Urine samples were obtained from 30 healthy volunteers and 328 type 2 diabetic patients with normoalbuminuria (n=114), microalbuminuria (n=100) and macroalbuminuria (n=114). The excretion levels of urinary periostin were quantified with enzyme-linked immunosorbent assay. Immunohistochemical periostin expression was determined in kidney tissues from overt diabetic nephropathy. RESULTS: Increased periostin expression in glomeruli and tubular epithelium in diabetic renal pathology was observed. Urinary periostin levels were significantly elevated in the patients of the normoalbuminuria [3.06 (IQR: 1.12, 6.77) ng/mgCr], microalbuminuria [8.71 (IQR: 5.09, 19.29) ng/mgCr] and macroalbuminuria [13.58 (IQR: 3.99, 16.19) ng/mgCr] compared with healthy controls [1.15 (IQR: 0.60, 1.63) ng/mgCr] (P<0.01).Increased urine periostin level significantly correlated with aging, high albuminuria and decline of GFR. Urine periostin ELISA also demonstrated high performance for the diagnosis of established normoalbuminuric, microalbuminuric and macroalbuminuric type 2 diabetes (AUC 0.78 (95%CI, 0.71 to 0.86), 0.99 (95%CI, 0.98 to 1.00) and 0.95 (95%CI, 0.91 to 0.98), respectively). CONCLUSION: The study indicates that increased urine periostin levels can be detected in patients with type 2 diabetes before the onset of significant albuminuria. Urinary periostin is an associated renal derangement in patients with established diabetic nephropathy and it may be used as an early marker of diabetic renal injury.
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Satirapoj et al. (2015) conducted a cross-sectional in Type 2 Diabetes Mellitus (n=358). Urinary periostin vs. Healthy controls was evaluated on Diagnosis of established normoalbuminuric type 2 diabetes (AUC 0.78, 95% CI 0.71 to 0.86). Urinary periostin levels were significantly elevated in patients with normoalbuminuric type 2 diabetes compared to healthy controls, yielding an AUC of 0.78 for the early detection of diabetic renal injury.
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