Keywords
Kidney Diseases
Biomarkers
Cytokines
Plasma
Urine
How to Cite
Abstract
Context: Type 2 diabetes mellitus (DM2) is a prevalent disease that can affect various organs. Diabetic kidney disease (DKD) is one of the complications of DM2.
Objective: To understand the sociodemographic and clinical characteristics, clinical laboratory findings, and interleukin (IL)-17 and IL-33 biomarkers in plasma and urine of our population with DM2 and DKD, and to determine if there are differences compared to patients without DKD and without DM2.
Methodology: This cross-sectional study obtained data from medical records. IL-17 and IL-33 levels in plasma and urine were measured using commercially available enzyme-linked immunosorbent assay kits.
Results: The study included 62 patients with DM2: 23 patients with DKD, 39 patients without DKD, and 29 patients without DM2. Patients with DM2 had higher levels of IL-17 in urine compared to patients without DM2 (p<0.001). Patients without DKD had higher levels of IL-33 in plasma compared to patients with DKD (p=0.0046). In patients with DM2, there was a positive correlation between IL-17 and IL-33 levels in urine. The plasma levels of IL-33 had an area under the curve of 0.74 in distinguishing between patients with and without DKD.
Conclusions: IL-17 levels in urine are higher in patients with DM2. IL-33 levels in plasma are higher in patients without DKD. The level of IL-33 in plasma could be useful in differentiating cases of DKD.
References
Mima A. A narrative review of diabetic kidney disease: previous and current evidence-based therapeutic approaches. Adv Ther. 2022;39(8):3488–3500. https://doi.org/10.1007/s12325-022-02223-0
Villegas Perrasse A, Abad SB, Faciolince S, Hernández N, et al. El control de la diabetes mellitus y sus complicaciones en Medellín, Colombia, 2001-2003. Rev Panam Salud Pública. 2006;20(6):393–402. https://doi.org/10.1590/S1020-49892006001100005
Castañeda Espinosa L, Losada Alvarez LM, Serna Flórez J, Duque Valencia JL, Nieto Cárdenas OA. Prevalencia de enfermedad renal crónica en un población con diabetes tipo 2 de un programa de riesgo cardiovascular. Rev Colomb Nefrol. 2020;7(2):55-66. https://doi.org/10.22265/acnef.7.2.481
Vargas-Uricoechea H, Casas-Figueroa LÁ. An Epidemiologic Analysis of Diabetes in Colombia. Ann Glob Health. 2015;81(6):742–753. https://doi.org/10.1016/j.aogh.2015.11.001
de Boer IH, Khunti K, Sadusky T, Tuttle KR, et al. Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO). Diabetes Care. 2022;45(12):3075–3090. https://doi.org/10.2337/dci22-0027
Hoogeveen EK. The epidemiology of diabetic kidney disease. Kidney Dial. 2022;2(3):433–442. https://doi.org/10.3390/kidneydial2030038
Tan X-Y, Jing H-Y, Ma Y-R. Interleukin-33/suppression of tumorigenicity 2 in renal fibrosis: emerging roles in prognosis and treatment. Front Physiol. 2022;12. https://doi.org/10.3389/fphys.2021.792897
Mohamed R, Jayakumar C, Chen F, Fulton D, et al. Low-dose il-17 therapy prevents and reverses diabetic nephropathy, metabolic syndrome, and associated organ fibrosis. J Am Soc Nephrol. 2016;27(3):745-765. https://doi.org/10.1681/ASN.2014111136
Basile DP, Ullah MM, Collet JA, Mehrotra P. T helper 17 cells in the pathophysiology of acute and chronic kidney disease. Kidney Res Clin Pract. 2021;40(1):12–28. https://doi.org/10.23876/j.krcp.20.185
Croghan CW, Egeghy PP. Methods of dealing with values below the limit of detection using SAS. Carolina del Norte: US-EPA, Research Triangle Park, NC. https://analytics.ncsu.edu/sesug/2003/SD08-Croghan.pdf
Anand G, Vasanthakumar R, Mohan V, Babu S, Aravindhan V. Increased IL-12 and decreased IL-33 serum levels are associated with increased Th1 and suppressed Th2 cytokine profile in patients with diabetic nephropathy (CURES-134). Int J Clin Exp Pathol. 2014;7(11):8008–8015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270517/
Erfurt S, Hoffmeister M, Oess S, Asmus K, et al. Serum IL-33 as a biomarker in different diseases: useful parameter or much need for clarification? J Circ Biomarkers. 2021;10(1):20–25. https://doi.org/10.33393/jcb.2021.2327
Nazarian A, Hejazian SM, Ahmadian E, Vahed SZ, et al. IL-17A rs2275913 gene polymorphism in patients with diabetic nephropathy. Immunopathol Persa. 2022:e29320. https://doi.org/10.34172/ipp.2022.29320
Mahmoud B, Abdel-Moneim A, Negeem Z, Nabil A. The relationship between B-cell lymphoma 2, interleukin-1?, interleukin-17, and interleukin-33 and the development of diabetic nephropathy. Mol Biol Rep. 2022;49:3803–3809. https://doi.org/10.1007/s11033-022-07221-7
Tang H, Liu N, Feng X, Yang Y, et al. Circulating levels of IL-33 are elevated by obesity and positively correlated with metabolic disorders in Chinese adults. J Transl Med. 2021;19:52. https://doi.org/10.1186/s12967-021-02711-x
Zhang Y, Bauersachs J, Langer HF. Immune mechanisms in heart failure. Eur J Heart Fail. 2017;19(11):1379–1389. https://doi.org/10.1002/ejhf.942
Biasucci LM, Maino A, Grimaldi MC, Cappannoli L, Aspromonte N. Novel biomarkers in heart failure: new insight in pathophysiology and clinical perspective. J Clin Med. 2021;10(13):2771. https://doi.org/10.3390/jcm10132771
Zhang C, Xiao C, Wang P, Xu W, et al. The alteration of Th1/Th2/Th17/Treg paradigm in patients with type 2 diabetes mellitus: relationship with diabetic nephropathy. Hum Immunol. 2014;75(4):289–296. https://doi.org/10.1016/j.humimm.2014.02.007
Ruopp MD, Perkins NJ, Whitcomb BW, Schisterman EF. Youden index and optimal cut-point estimated from observations affected by a lower limit of detection. Biom J. 2008;50(3):419-430. https://doi.org/10.1002/bimj.200710415
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2023 Revista Colombiana de Endocrinología, Diabetes & Metabolismo