Clinical significance of urinary Monocyte Chemoattractant Protein-1 (uMCP-1) in Indian type 2 diabetic patients at different stages of diabetic nephropathy

Abstract 

Objective

Monocyte Chemoattractant Protein-1 (MCP-1) is the strongest known chemotactic factor for monocytes and is upregulated in diabetic nephropathy. So measuring urinary MCP-1 is of great significance in the diagnosis and intervention of early diabetic nephropathy. This study aims at determining the levels of urinary MCP-1 (uMCP-1) at different stages of diabetic nephropathy and to see its correlation with other parameters in Indian type2 diabetic subjects.

Materials and methods

A total of 64 (M:F; 40:24) type 2 diabetic subjects were divided into three groups based on their renal function and were compared with non-diabetic controls (Group 1) n=20 (M:F; 13:7). The study groups were Group 2 (normoalbuminuria) n=16, Group 3 (microalbuminuria) n=23 and Group 4 (macroalbuminuria) n=25. Demographic, anthropometric and biochemical details were recorded for all the subjects. Urinary MCP-1 levels were measured by using solid phase ELISA method.

Results

Mean levels of uMCP-1 in subjects with type 2 diabetes were significantly higher than in controls (p<0.05). The levels of uMCP-1 in type 2 diabetic subjects increased gradually with deteriorating renal function (p=0.006). There was a significant difference in urinary MCP-1 levels between Group 2 and Group 1 (p<0.001). Levels of uMCP-1 were significantly higher in subjects with eGFR <60ml/min compared to eGFR >60ml/min (p=0.008). uMCP-1 levels correlated positively with uACR or uPCR (r=0.551, p<0.0001), urea (r=0.43, p<0.0001) and creatinine (r=0.478, p<0.0001). A negative correlation between uMCP-1 and eGFR (r=−0.338, p=0.006) was noted.

Conclusion

Our study demonstrated that urinary MCP-1 levels increased gradually in type 2 diabetic subjects with deteriorating renal function. It is significantly associated with the other risk factors of diabetic nephropathy.

Keywords: Urinary MCP-1, Diabetic nephropathy, Type 2 diabetes, India