Significance of Urinary Monocyte Chemoattractant Protein-1 in Early Detection of Nephropathy in Type 2 Diabetic Patients
Mona I Nabih1, Ahmed El-Mazny1, Nadia A Mohamed1 and Amal R El-Shehaby2
Departments of Internal Medicine1 and Medical Biochemistry2, Faculty of Medicine Cairo University
Abstract: Objective: Monocyte Chemoattractant Protein-1 (MCP-1) is the strongest known monocytes chemotactic factor and has been implicated in the development and progression of diabetic nephropathy. So, measuring urinary MCP-1 would be of great significance in the diagnosis and intervention of diabetic nephropathy. This study aimed at determining the levels of urinary MCP-1 (uMCP-1) at different stages of diabetic nephropathy and to study its correlation with other clinical and laboratory parameters in Egyptian type 2 diabetic subjects. Materials and methods: A total of 45 type 2 diabetic subjects were classified into three groups based on their urinary albumin excretion and were compared with non-diabetic controls (Group IV) (n=15). The groups of diabetic subjects were Group I (normoalbuminuria) (n=15), Group II (microalbuminuria) (n=15) and Group III (macroalbuminuria) (n=15). The four groups were age and sex matched. Medical history, clinical examination, anthropometric and biochemical details were recorded for all the subjects. Urinary MCP-1 levels were measured by using solid phase ELISA method. Results: The mean level of uMCP-1 in patients with type 2 diabetes was significantly higher than in control subjects (p<0.0001) and the mean level of uMCP-1 in the normoalbuminuric group was significantly higher than in the controls (p<0.0001). Compared with the normoalbuminuric group, the mean levels of uMCP-1 in the microalbuminuric and macroalbuminuric groups were significantly higher (p<0.0001). Also, the mean level of uMCP-1 in the macroalbuminuric group was significantly higher than that in the microalbuminuric group (P<0.0001). The levels of uMCP-1 were positively correlated with the levels of albuminuria in all diabetics (p< 0.0001) and in the macroalbuminuric group (p<0.05). The levels of uMCP-1 were significantly negatively correlated with eGFR in the microalbumnuric group (p< 0.05). The levels of uMCP-1 correlated positively with HbA1C in all diabetics (r=0.6, p<0.0001) and in the macroalbuminuric group (r = 0.6, p < 0.05) and correlated positively with serum total cholesterol (r=0.7, p<0.0001) and LDL-C in diabetic patients (r=0.7, p<0.0001). Conclusion: Our study demonstrated that urinary MCP-1 levels increased gradually in type 2 diabetic subjects with increased albuminuria. It is significantly associated with the same risk factors of diabetic nephropathy.
[Mona I Nabih, Ahmed El-Mazny, Nadia A Mohamed and Amal R El-Shehaby. Significance of Urinary Monocyte Chemoattractant Protein-1 in Early Detection of Nephropathy in Type 2 Diabetic Patients. Life Sci J2013; 10(1):3030-3039]. (ISSN: 1097-8135). http://www.lifesciencesite.com. 2
Key words: Diabetes mellitus, diabetic nephropathy, cytokines, monocyte chemoattractant protein .