Key result
Higher pulse pressure and MAP link to lower urinary EGF in boys with obesity or T1D.
Why the study?
The interplay between urinary epidermal growth factor, serum renin, and blood pressure in children with obesity or type 1 diabetes and its impact on vascular and kidney health is not well understood.
Observational (n=273)
No
Effect estimate: Coefficient -0.014
p-value: p=0.001
In boys with obesity or type 1 diabetes, increased pulse pressure and mean arterial pressure are associated with decreased urinary epidermal growth factor, suggesting a link between blood pressure and early nephron dysfunction.
Urinary EGF may flag early nephron stress from pulse pressure in boys with obesity or T1DM; leaves open prospective validation before any clinical role.
An increased blood pressure is a known comorbidity of both type 1 diabetes (T1DM) and obesity in children. Increasing evidence suggests a subtle interplay between epidermal growth factor (EGF) and renin along the juxtaglomerular system, regulating the impact of blood pressure on kidney health and the cardiovascular system. In this study, we investigated the relation between urinary EGF, serum renin and blood pressure in children with obesity or T1DM. 147 non-obese children with T1DM and 126 children with obesity, were included. Blood pressure was measured and mean arterial pressure (MAP) and the pulse pressure (PP) were calculated. Serum renin and urinary EGF levels were determined with a commercial ELISA kit. Partial Spearman rank correlation coefficients and multiple linear regression models were used to study the association between renin, the urinary EGF/urinary creatinine ratio and blood pressure parameters. The urinary EGF/urinary creatinine ratio is correlated with the SBP and the MAP in boys with obesity as well as in boys with T1DM. Multiple regression analysis showed that sex and pulse pressure in male subjects were found to be independently associated with renin. Sex, the presence of diabetes, age, the glomerular filtration rate and both pulse pressure and mean arterial pressure in male subjects were independently associated with urinary EGF/urinary creatinine. In conclusion, in boys with either obesity or diabetes, pulse pressure and mean arterial pressure are negatively associated with the functional integrity of the nephron, which is reflected by a decreased expression of urinary EGF.
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Ledeganck et al. (2023) conducted an observational in Obesity or Type 1 Diabetes (n=273). Pulse pressure and mean arterial pressure was evaluated on Association of mean arterial pressure with log-transformed urinary EGF/creatinine ratio in males (Coefficient -0.014, p=0.001). In boys with either obesity or type 1 diabetes, pulse pressure and mean arterial pressure were independently and negatively associated with urinary epidermal growth factor excretion, suggesting early preclinical impaired vascular health.
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