Abstract
Introduction Uromodulin is a kidney-specific tubular protein, and its
assessment in serum (sUMOD) reveals the potential as a novel marker for function
and the integrity of renal parenchymal cells and does not directly depend on the
glomerular filtration rate. Early diabetic nephropathy parallels glomerular
hyperfiltration, often leading to diagnostic misinterpretation. Moreover,
traditional kidney function markers are not able to diagnose structural lesions.
Recent data show that sUMOD is linked to glucose intolerance in adults. Thus, we
launched to assess the hypothesis that sUMOD is also associated with kidney
function, biometric data, and quality of metabolic control in
children/adolescents with type 1 diabetes.
Patients and methods Patients with type 1 diabetes (n=135) and
healthy controls (n=69) were recruited to participate in the trial.
Clinical, biometrical data, sUMOD, and other laboratory parameters were
assessed.
Results The mean concentrations of sUMOD in diabetic patients and controls
were comparable (201.19±103.22 vs.
198.32±84.27 ng/mL, p=0.832). However, in
contrast to healthy controls, sUMOD levels in patients with diabetes were
associated with serum-creatinine (r=−0.368, p<0.0001),
age (r=−0.350, p<0.0001), height
(r=−0.379, p<0.0001), body weight
(r=−0.394, p<0.0001), Body mass index
(r=−0.292, p=0.001), daily insulin dosage
(r=−0.300, p<0.0001), HbA1c (%)
(r=−0.190, p=0.027), standardized HbA1c/IFCC
(mmol/mol) (r=−0.189, p=0.028), and systolic
(r=−0.299, p<0.0001) and diastolic
(r=−0.235, p=0.006) arterial blood pressure.
Conclusions Our study shows that children/adolescents with type 1
diabetes disclose similar sUMOD concentrations as healthy controls. Serum UMOD
appears to indicate higher risks for kidney tissue remodeling and possibly
subsequent cardiovascular alterations. However, further studies are mandatory to
settle these findings.
Key words
Serum uromodulin - ELISA - kidney biomarker - juvenile type 1 diabetes - risk assessment
