Clinical significance of urinary Monocyte Chemoattractant Protein-1 (uMCP-1) in Indian type 2 diabetic patients at different stages of diabetic nephropathy
Received 20 July 2009; received in revised form 25 September 2009; accepted 13 October 2009. published online 23 November 2009.
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.
M.V. Hospital for Diabetes and Diabetes Research Centre, No. 5, Main Road, Royapuram, Chennai 600 013, India
Corresponding author. Address: Diabetes Research Centre, WHO Collaborating Centre for Research, Education and Training in Diabetes, No. 5, Main Road, Royapuram, Chennai 600 013, India. Tel.: +91 44 2595 49 13–15; fax: +91 44 2595 49 19.
ABSTRACT