Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes
Апстракт
Background:Since the increase in some tubular damage biomarkers can be observed at the early stage of diabetic nephropathy, even in the absence of albuminuria, we aimed to investigate if urinary albumin is superior than tubular damage marker, such as serum retinol-binding protein 4 (RBP4), in predicting renal function decline (defined as estimated glomerular filtration rate [eGFR] lt 60 mL/min/1.73 m(2)) in the cohort of patients with type 2 diabetes mellitus (T2D).MATERIALS AND Methods:A total of 106 sedentary T2D patients (mean [+/- standard deviation] age 64.9 [+/- 6.6] years) were included in this cross-sectional study. Anthropometric and biochemical parameters (fasting glucose, glycated hemoglobin [HbA1c], lipid parameters, creatinine, RBP4, high sensitivity C-reactive protein [hsCRP], urinary albumin excretion [UAE]), as well as blood pressure were obtained.Results:HsCRP (odds ratio [OR] =0.754, 95% confidence interval [CI] (0.603-0.942), P = 0.013) and RBP4 (OR = 0.873, 95% CI ...[0.824-0.926], P lt 0.001) were independent predictors of eGFR decline. Moreover, although RBP4 and UAE as single diagnostic parameters of renal impairment showed excellent clinical accuracy (area under the curve [AUC] = 0.900 and AUC = 0.940, respectively), the Model which included body mass index, HbA1c, triglycerides, hsCRP, and RBP4 showed statistically same accuracy as UAE, when UAE was used as a single parameter (AUC = 0.932 vs. AUC = 0.940, respectively; P for AUC difference = 0.759). As well, the Model had higher sensitivity and specificity (92% and 90%, respectively) than single predictors, RBP4, and UAE.Conclusion:Although serum RBP4 showed excellent clinical accuracy, just like UAE, a combination of markers of tubular damage, inflammation, and traditional markers has the higher sensitivity and specificity than UAE alone for prediction renal impairment in patients with T2D.
Кључне речи:
Albuminuria / diabetic nephropathy / inflammation / retinol-binding protein 4Извор:
Journal of Research in Medical Sciences, 2018, 23Издавач:
- Wolters Kluwer Medknow Publications, Mumbai
Финансирање / пројекти:
DOI: 10.4103/jrms.JRMS_893_17
ISSN: 1735-1995
PubMed: 29937906
WoS: 000444504600006
Scopus: 2-s2.0-85048258164
Институција/група
PharmacyTY - JOUR AU - Klisić, Aleksandra AU - Kavarić, Nebojša AU - Ninić, Ana PY - 2018 UR - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3082 AB - Background:Since the increase in some tubular damage biomarkers can be observed at the early stage of diabetic nephropathy, even in the absence of albuminuria, we aimed to investigate if urinary albumin is superior than tubular damage marker, such as serum retinol-binding protein 4 (RBP4), in predicting renal function decline (defined as estimated glomerular filtration rate [eGFR] lt 60 mL/min/1.73 m(2)) in the cohort of patients with type 2 diabetes mellitus (T2D).MATERIALS AND Methods:A total of 106 sedentary T2D patients (mean [+/- standard deviation] age 64.9 [+/- 6.6] years) were included in this cross-sectional study. Anthropometric and biochemical parameters (fasting glucose, glycated hemoglobin [HbA1c], lipid parameters, creatinine, RBP4, high sensitivity C-reactive protein [hsCRP], urinary albumin excretion [UAE]), as well as blood pressure were obtained.Results:HsCRP (odds ratio [OR] =0.754, 95% confidence interval [CI] (0.603-0.942), P = 0.013) and RBP4 (OR = 0.873, 95% CI [0.824-0.926], P lt 0.001) were independent predictors of eGFR decline. Moreover, although RBP4 and UAE as single diagnostic parameters of renal impairment showed excellent clinical accuracy (area under the curve [AUC] = 0.900 and AUC = 0.940, respectively), the Model which included body mass index, HbA1c, triglycerides, hsCRP, and RBP4 showed statistically same accuracy as UAE, when UAE was used as a single parameter (AUC = 0.932 vs. AUC = 0.940, respectively; P for AUC difference = 0.759). As well, the Model had higher sensitivity and specificity (92% and 90%, respectively) than single predictors, RBP4, and UAE.Conclusion:Although serum RBP4 showed excellent clinical accuracy, just like UAE, a combination of markers of tubular damage, inflammation, and traditional markers has the higher sensitivity and specificity than UAE alone for prediction renal impairment in patients with T2D. PB - Wolters Kluwer Medknow Publications, Mumbai T2 - Journal of Research in Medical Sciences T1 - Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes VL - 23 DO - 10.4103/jrms.JRMS_893_17 ER -
@article{ author = "Klisić, Aleksandra and Kavarić, Nebojša and Ninić, Ana", year = "2018", abstract = "Background:Since the increase in some tubular damage biomarkers can be observed at the early stage of diabetic nephropathy, even in the absence of albuminuria, we aimed to investigate if urinary albumin is superior than tubular damage marker, such as serum retinol-binding protein 4 (RBP4), in predicting renal function decline (defined as estimated glomerular filtration rate [eGFR] lt 60 mL/min/1.73 m(2)) in the cohort of patients with type 2 diabetes mellitus (T2D).MATERIALS AND Methods:A total of 106 sedentary T2D patients (mean [+/- standard deviation] age 64.9 [+/- 6.6] years) were included in this cross-sectional study. Anthropometric and biochemical parameters (fasting glucose, glycated hemoglobin [HbA1c], lipid parameters, creatinine, RBP4, high sensitivity C-reactive protein [hsCRP], urinary albumin excretion [UAE]), as well as blood pressure were obtained.Results:HsCRP (odds ratio [OR] =0.754, 95% confidence interval [CI] (0.603-0.942), P = 0.013) and RBP4 (OR = 0.873, 95% CI [0.824-0.926], P lt 0.001) were independent predictors of eGFR decline. Moreover, although RBP4 and UAE as single diagnostic parameters of renal impairment showed excellent clinical accuracy (area under the curve [AUC] = 0.900 and AUC = 0.940, respectively), the Model which included body mass index, HbA1c, triglycerides, hsCRP, and RBP4 showed statistically same accuracy as UAE, when UAE was used as a single parameter (AUC = 0.932 vs. AUC = 0.940, respectively; P for AUC difference = 0.759). As well, the Model had higher sensitivity and specificity (92% and 90%, respectively) than single predictors, RBP4, and UAE.Conclusion:Although serum RBP4 showed excellent clinical accuracy, just like UAE, a combination of markers of tubular damage, inflammation, and traditional markers has the higher sensitivity and specificity than UAE alone for prediction renal impairment in patients with T2D.", publisher = "Wolters Kluwer Medknow Publications, Mumbai", journal = "Journal of Research in Medical Sciences", title = "Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes", volume = "23", doi = "10.4103/jrms.JRMS_893_17" }
Klisić, A., Kavarić, N.,& Ninić, A.. (2018). Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes. in Journal of Research in Medical Sciences Wolters Kluwer Medknow Publications, Mumbai., 23. https://doi.org/10.4103/jrms.JRMS_893_17
Klisić A, Kavarić N, Ninić A. Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes. in Journal of Research in Medical Sciences. 2018;23. doi:10.4103/jrms.JRMS_893_17 .
Klisić, Aleksandra, Kavarić, Nebojša, Ninić, Ana, "Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes" in Journal of Research in Medical Sciences, 23 (2018), https://doi.org/10.4103/jrms.JRMS_893_17 . .