Urinary heme oxygenase‐1 as a potential biomarker for early diabetic nephropathy. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Li, Zhenzhen; Xu, Yuliang; Liu, Xianghua; Nie, Yali; Zhao, Zhanzheng
• Is Part Of: Nephrology. Volume 22:Issue 1(2017)
• Page Start: 58
• Page End: 64
• Publication Date: 2017-01
• Subjects: Biomarker -- Diabetic nephropathy -- Heme oxygenase‐1 -- Oxidative stress -- Urinary; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.12719
• Languages: English
• ISSNs: 1320-5358

Abstract

Abstract: Background: Our previous study showed that increases of urinary heme oxygenase‐1 (uHO‐1) could be a potential biomarker indicating evaluating intrarenal oxidative damage in obstructive nephropathy. Activation of oxidative stress is an important mediator of diabetic nephropathy (DN). The aim of this study was to investigate the clinical implications of uHO‐1 levels in patients with type 2 diabetes. Methods: Eighty‐four type 2 diabetic patients with normoalbuminuria (n=28), microalbuminuria (n=28), and macroalbuminuria (n=28) were included in this study. Control samples were collected from healthy volunteers (n=28) who had normal albuminuria and renal function. Urine HO‐1 levels were evaluated by enzyme‐linked immunosorbent assay. Results: Urinary HO‐1/creatinine (cr.) levels were significantly elevated in diabetic patients with microalbuminuria and macroalbuminuria compared to those in diabetic patients with normoalbuminuria ( P <0.001) and control subjects (all P <0.001). In diabetic patients with normoalbuminuria, uHO‐1/cr. levels were also higher than those in controls ( P <0.001). Multivariate regression analyses revealed that uHO‐1/cr. levels were positively correlated to urinary albumin/creatinine ratio and inversely correlated to glomerular filtration rate. Receiver operating characteristic (ROC) curve analysis of uHO‐1/cr. levels for early diagnosis and detection of DN revealed that the cut‐off value of uHO‐1/cr. was 4.59 ng/mg (sensitivity 75%, specificity 78.6%). Conclusions: The findings of this study indicate that increases of urine HO‐1 levels can be detected in patients with type 2 diabetes before the onset of significant albuminuria, and associated with renal derangement in patients with established diabetic nephropathy. Urinary HO‐1 may be used as an early biomarker for diabetic renal injury. Summary at a Glance: The authors found that urinary HO‐1/cr. levels were positively correlated to urinary albumin/creatinine ratio and inversely correlated to glomerular filtration rate in diabetes. They have concluded thatUrinary HO‐1 may be used as an early biomarker for diabetic renal injury.