Abstract

Background: The relationship between certain trace mineral elements and type 2 diabetes remains complex, and an alteration in the metabolism of these trace elements has been reported by some studies to be the cause of the development of diabetes or its complications. Aim: In order to study the role that copper could play in type 2 diabetes and more particularly in diabetic nephropathy, we evaluated the link between the status of urinary copper and microalbuminuria (biomarker of renal damage) in Algerian patients with type 2 diabetes. Method: The study involved a total of 46 unbalanced T2DM subjects with HbA1c> 7 (G1) and 50 well balanced T2DM subjects (G2) as well as 40 controls (G3). The respective mean age is estimated at 65.42 ± 4.07 years for G1 and 56.15 ± 6.66 years for G2 and 44.33 ± 3.47 years for G3. All study subjects were normotensive. A 24-hour urine copper assay on the thermo Fisher ICE 3300 atomic absorption spectrometer was performed for all patients, as well as a microalbuminuria assay on the Siemens DCA Vantage. Results: In this study, G1 had the highest urinary copper levels (p <0.001). A strong positive and significant correlation was found between urinary copper levels and microalbuminuria in G1 (r = 0.67) (p <0.01). The same is true for G2 where a weaker correlation was observed (r = 0.38), it nevertheless remains significant (p <0.01). Discussion: This study shows significantly higher urinary copper levels in diabetic patients with microalbuminuria than in patients without it. This high urinary Cu excretion may be due to the excretion of its transporter proteins. Urinary copper excretion may also be due to dissociations of the copper-albumin and ceruloplasmin-copper complexes, which are filtered by the damaged glomerulus and which may play a role in the progression of nephropathy in patients with nephropathy advanced.

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