目前，没有生物标志物可以预测2型糖尿病（T2D）患者何时会发展为更严重的肾脏疾病，即糖尿病肾病(DN)。可以识别有进展风险的患者的生物标志物将允许更早，更积极的治疗干预和管理，降低患者发病率和死亡率。
研究参与者（N=88；对照n=26；T2Dn=32；DNn=30）从安特里姆地区医院的肾脏单元招募，安特里姆,英国;Whiteabbey医院糖尿病诊所,纽敦修道院,英国；阿尔斯特大学（UU），贝尔法斯特,英国;和第三年龄大学（U3A），贝尔法斯特,英国；2019年至2020年。收集静脉血和尿液以及每个研究参与者的详细临床病史。
总共，13/25（52.0%）在尿液中测量的生物标志物和25/34（73.5%）在血清中测量的生物标志物被鉴定为对照之间的显著差异。T2D和DN参与者。DN患者,年纪大了,熏得更多，收缩压较高，血清肌酐水平较高，eGFR功能较低。血清生物标志物与eGFR显著负相关。
这项初步研究确定了几种血清生物标志物，可用于预测T2D向更严重的肾脏疾病的进展：midkine,sTNFR1和2，H-FABP和胱抑素C。我们的结果值得在使用更大患者队列的纵向研究中得到证实。
Currently there are no biomarkers that are predictive of when patients with type-2 diabetes (T2D) will progress to more serious kidney disease i.e., diabetic nephropathy (DN). Biomarkers that could identify patients at risk of progression would allow earlier, more aggressive treatment intervention and management, reducing patient morbidity and mortality.
Study participants (N=88; control n=26; T2D n=32; DN n=30) were recruited from the renal unit at Antrim Area Hospital, Antrim, UK; Whiteabbey Hospital Diabetic Clinic, Newtownabbey, UK; Ulster University (UU), Belfast, UK; and the University of the Third Age (U3A), Belfast, UK; between 2019 and 2020. Venous blood and urine were collected with a detailed clinical history for each study participant.
In total, 13/25 (52.0%) biomarkers measured in urine and 25/34 (73.5%) biomarkers measured in serum were identified as significantly different between control, T2D and DN participants. DN patients, were older, smoked more, had higher systolic blood pressure and higher serum creatinine levels and lower eGFR function. Serum biomarkers significantly inversely correlated with eGFR.
This pilot-study identified several serum biomarkers that could be used to predict progression of T2D to more serious kidney disease: namely, midkine, sTNFR1 and 2, H-FABP and Cystatin C. Our results warrant confirmation in a longitudinal study using a larger patient cohort.
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