Serum Angiopoeitin Like-4 As An Early Detection Marker Of Diabetic Kidney Disease
DOI:
https://doi.org/10.59188/eduvest.v4i6.1459Keywords:
ANGPTL4 serum, DKD, UACR, eGFRAbstract
Diabetic kidney disease (DKD) is a long-term complication of diabetes mellitus (DM). The gold standard for diagnosis of DKD is kidney biopsy, but it is difficult to perform. Several clinical conditions have found an association between higher ANGPTL4 plasma levels in DKD. Methods: A total of 87 patients with Type 2 DM were analysed using an observational analytic method with a cross-sectional design. The study subjects were divided into DKD and non DKD groups, then serum ANGPTL4 was measured using the sandwich ELISA method. Furthermore, ANGPTL index cutoff was determined. Several other variables including glycemic control, duration of DM, history of hypertension, and dyslipidemia were analysed for their association with DKD and non DKD groups. The study continued by conducting multivariate analysis with logistic regression. Results: A total of 23 (26.4%) subjects were classified as DKD and 64 (73.6%) subjects as non DKD. ANGPTL cutoff determination of 16.64 ng/mL had a sensitivity and specificity of 87% and 51.6%, respectively. Bivariate analysis showed glycaemic control, duration of DM, and serum ANGPTL4 (p=0.044; p=0.009; p=0.014) were associated with the incidence of DKD. Multivariate analysis showed that serum ANGPTL4 with a cutoff of >16.64 ng/mL could be used as an independent predictor of DKD incidence with an adjusted OR of 6.73 (95%CI= 1.79-25.30; p=0.005). Conclusion: serum ANGPTL4 is an independent predictor of DKD. Suggestion: Urine sampling for UACR examination twice, periodic examination of serum ANGPTL4 levels to assess the progressiveness of DKD.
References
Agarwal, R. (2021). Pathogenesis of diabetic nephropathy.
Al Shawaf, E., Abu-Farha, M., Devarajan, S., Alsairafi, Z., Al-Khairi, I., Cherian, P., Ali, H., Mathur, A., Al-Mulla, F., & Al Attar, A. (2019). ANGPTL4: a predictive marker for diabetic nephropathy. Journal of Diabetes Research, 2019(1), 4943191.
Banerjee, D., Winocour, P., Chowdhury, T. A., De, P., Wahba, M., Montero, R., Fogarty, D., Frankel, A. H., Karalliedde, J., & Mark, P. B. (2022). Management of hypertension and renin-angiotensin-aldosterone system blockade in adults with diabetic kidney disease: Association of British Clinical Diabetologists and the Renal Association UK guideline update 2021. BMC Nephrology, 23, 1–31.
Bano, G., Imam, M. T., Bajpai, R., Alem, G., Kashyap, V. K., Habib, A., & Najmi, A. K. (2023). Expression of angiopoetin-like protein-4 and kidney injury molecule-1 as preliminary diagnostic markers for diabetes-related kidney disease: A single center-based cross-sectional study. Journal of Personalized Medicine, 13(4), 577.
Farah, R. I., Al-Sabbagh, M. Q., Momani, M. S., Albtoosh, A., Arabiat, M., Abdulraheem, A. M., Aljabiri, H., & Abufaraj, M. (2021). Diabetic kidney disease in patients with type 2 diabetes mellitus: a cross-sectional study. BMC Nephrology, 22(1), 223.
Galindo, R. J., Beck, R. W., Scioscia, M. F., Umpierrez, G. E., & Tuttle, K. R. (2020). Glycemic monitoring and management in advanced chronic kidney disease. Endocrine Reviews, 41(5), 756–774.
Heo, G. Y., Koh, H. B., Kim, H. W., Park, J. T., Yoo, T.-H., Kang, S.-W., Kim, J., Kim, S. W., Kim, Y. H., & Sung, S. A. (2023). Glycemic control and adverse clinical outcomes in patients with chronic kidney disease and type 2 diabetes mellitus: results from KNOW-CKD. Diabetes & Metabolism Journal, 47(4), 535.
Hirano, T., Satoh, N., Kodera, R., Hirashima, T., Suzuki, N., Aoki, E., Oshima, T., Hosoya, M., Fujita, M., & Hayashi, T. (2022). Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross‐sectional study from a regional diabetes cohort. Journal of Diabetes Investigation, 13(4), 657–667.
Hoogeveen, E. K. (2022). The epidemiology of diabetic kidney disease. Kidney and Dialysis, 2(3), 433–442.
Ishtiaq, S. M., Rashid, H., Hussain, Z., Arshad, M. I., & Khan, J. A. (2019). Adiponectin and PPAR: a setup for intricate crosstalk between obesity and non-alcoholic fatty liver disease. Reviews in Endocrine and Metabolic Disorders, 20, 253–261.
Kebede, S. A., Tusa, B. S., Weldesenbet, A. B., Tessema, Z. T., & Ayele, T. A. (2021). Incidence of diabetic nephropathy and its predictors among type 2 diabetes mellitus patients at university of gondar comprehensive specialized hospital, Northwest Ethiopia. Journal of Nutrition and Metabolism, 2021(1), 6757916.
Li, J., Li, L., Guo, D., Li, S., Zeng, Y., Liu, C., Fu, R. U., Huang, M., & Xie, W. (2020). Triglyceride metabolism and angiopoietin-like proteins in lipoprotein lipase regulation. Clinica Chimica Acta, 503, 19–34.
Morelli, M. B., Chavez, C., & Santulli, G. (2020). Angiopoietin-like proteins as therapeutic targets for cardiovascular disease: focus on lipid disorders. Expert Opinion on Therapeutic Targets, 24(1), 79–88.
Qazi, M., Sawaf, H., Ismail, J., Qazi, H., & Vachharajani, T. (2022). Pathophysiology of Diabetic Kidney Disease. Nephrology, 10(1), 102–113.
Qin, L., Zhang, R., Yang, S., Chen, F., & Shi, J. (2019). Knockdown of ANGPTL-4 inhibits inflammatory response and extracellular matrix accumulation in glomerular mesangial cells cultured under high glucose condition. Artificial Cells, Nanomedicine, and Biotechnology, 47(1), 3368–3373.
Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., Colagiuri, S., Guariguata, L., Motala, A. A., & Ogurtsova, K. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes Research and Clinical Practice, 157, 107843.
Selby, N. M., & Taal, M. W. (2020). An updated overview of diabetic nephropathy: Diagnosis, prognosis, treatment goals and latest guidelines. Diabetes, Obesity and Metabolism, 22, 3–15.
Shuff, S., Oyama, Y., Walker, L., & Eckle, T. (2021). Circadian angiopoietin-like-4 as a novel therapy in cardiovascular disease. Trends in Molecular Medicine, 27(7), 627–629.
Siddiqui, K., George, T. P., Joy, S. S., & Alfadda, A. A. (2022). Risk factors of chronic kidney disease among type 2 diabetic patients with longer duration of diabetes. Frontiers in Endocrinology, 13, 1079725.
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