#6545 URINARY FETUIN-A FRAGMENT EXCRETION IN PATIENTS WITH TYPE 2 DIABETES AND ITS CORRELATION WITH RENAL FUNCTION

Abstract

Abstract Background and Aims Fetuin-A is associated with production of pro-inflammatory cytokines, which can lead to progression of vascular complications in patients with diabetes. We planned a study to evaluate the correlation of urinary excretion of post translationally modified fetuin-A fragment (PTM Fetuin A) with albuminuria and chronic kidney disease. Method We conducted a cross-sectional study between July to August 2022 in patients with type 2 diabetes. The baseline characteristics such as Age, Gender, history of Diabetes Mellitus, Hypertension, Cardiac disease, and CKD were obtained. The subject's blood pressure, Haemoglobin, Random blood sugar, Creatinine, was obtained, and eGFR (Glomerular Filtration Rate) was calculated using the CKD-EPI equation. The spot urine was tested for urine albumin to creatinine ratio (UACR) and PTM-Fetuin-A: Creatinine ratio (FCR). PTM-Fetuin A was measured by an ELISA using DNlite-IVD103 ELISA test kit, Bio Preventive Medicine Corp, Taiwan. Results A total of 68 subjects were included, with 37 being men (54.4%). The mean age, eGFR, UACR, and FCR were 55 ± 11.4 years, 61.9 ± 37.5 ml/min/1.73 m2, 1060.7 ± 1550 mg/g, and 522.2 ± 915.1 ng/g respectively. There was significant positive correlation between FCR and UACR (p<0.005), serum creatinine (p<0.005), and eGFR (p<0.001). There was a trend noted of increasing PTM-Fetuin A levels and UACR with worsening eGFR. The AUROC for UACR and FCR for predicting patients with CKD stage 3 onwards were 0.703 and 0.789 respectively (Figure 1). In our study, the significance of predicting CKD stage 3 onwards with a UACR cut-off of 300 mg/g, UACR cut-off of 1150 mg/g and a FCR cut-off of 123 ng/g were p = 0.008, p = 0.003, and p<0.0001 respectively. Conclusion PTM-Fetuin A is significantly associated with worsening renal function. It has very significant correlation with the albuminuria, and at a FCR cut-off of 123 ng/g, it could significantly differentiate CKD stages, compared to UACR. Further prospective studies are needed to evaluate the correlation between PTM-Fetuin A levels and rate of progression of nephropathy.