Serum and urinary pentraxin-3 levels in type 2 diabetes and its relation to diabetic nephropathy

Abstract

BackgroundDiabetic nephropathy (DN) is the most common cause of end-stage renal disease. Microalbuminuria is the most popular method for detecting the early signs of DN. However, pathological changes occur before the onset of microalbuminuria. So, there is a need for another biomarkers that might provide a sensitive and fast means for identification of the progression of DN. Pentraxin 3 (PTX3) is an acute-phase glycoprotein and a soluble receptor acting as an opsonin. PTX3 protein is expressed in vascular endothelial cells and macrophages. Thereby, its levels may reflect more directly the inflammatory status of the vasculature.AimEvaluation of the levels of serum and urinary PTX3 in type 2 diabetes mellitus (T2DM) patients and its relation to DN.Patients and methodsGroup A: 20 healthy volunteers (control group). Group B: 20 patients with normoalbuminuric T2DM. Group C: 20 patients with microalbuminuric T2DM. Group D: 20 patients with macroalbuminuric T2DM. Also all the participants divided into two subgroups: Group 1: 40 participants with no nephropathy (controls and normoalbuminuric patients). Group 2: 40 patients with nephropathy (microalbuminuric and macroalbuminuric patients).ResultsThere was no significant difference among all studied groups with respect to age, sex, lipid profile, urinary PTX3, C-reactive protein, and liver function test. Whereas BMI, hemoglobin level, HBA1C, fasting blood sugar, postprandial blood sugar, serum creatinine, estimated glomerular filtration rate, and 24 h urinary albumin excretion; showed high significant difference among all studied groups.Serum albumin and total protein levels were highly significantly decreased in macroalbumiuric group as a result of proteinuria compared to the other three groups Serum PTX3 showed high significant difference between nephropathic (micro and macroalbuminuric) group and non nephropathic group (control and normoalbuminuric).There were highly significant positive correlations between serum PTX3 and (fasting blood sugar, postprandial blood sugar, HBA1C, and 24 h urinary albumin) significant positive correlation with serum creatinine, whereas there were highly significant negative correlations between serum PTX3 and serum total protein and serum albumin.ConclusionSerum PTX3 increased progressively with DN and may be a serum biomarker for early diagnosis of DN. Whereas urinary PTX3 has no relation to DN.