Biomarkers associated with early stages of kidney disease in adolescents with type 1 diabetes

  • , Maria Loredana Marcovecchio (Lead / Corresponding author)
  • , Marco Colombo
  • , Raymond Neil Dalton
  • , Paul M. McKeigue
  • , Paul Benitez-Aguirre
  • , Fergus J. Cameron
  • , Scott T. Chiesa
  • , Jennifer J. Couper
  • , Maria E. Craig
  • , Denis Daneman
  • , Elizabeth A. Davis
  • , John E. Deanfield
  • , Kim C. Donaghue
  • , Timothy W. Jones
  • , Farid H. Mahmud
  • , Sally M. Marshall
  • , Andrew Neil
  • , Helen M. Colhoun
  • , David B. Dunger

    Research output: Contribution to journalArticlepeer-review

    70 Downloads (Pure)

    Abstract

    Objectives: To identify biomarkers of renal disease in adolescents with type 1 diabetes (T1D) and to compare findings in adults with T1D. Methods: Twenty-five serum biomarkers were measured, using a Luminex platform, in 553 adolescents (median [interquartile range] age: 13.9 [12.6, 15.2] years), recruited to the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial. Associations with baseline and final estimated glomerular filtration rate (eGFR), rapid decliner and rapid increaser phenotypes (eGFR slopes <−3 and > 3 mL/min/1.73m2/year, respectively), and albumin-creatinine ratio (ACR) were assessed. Results were also compared with those obtained in 859 adults (age: 55.5 [46.1, 64.4) years) from the Scottish Diabetes Research Network Type 1 Bioresource. 

    Results: In the adolescent cohort, baseline eGFR was negatively associated with trefoil factor-3, cystatin C, and beta-2 microglobulin (B2M) (B coefficient[95%CI]: −0.19 [−0.27, −0.12], P = 7.0 × 10−7; −0.18 [−0.26, −0.11], P = 5.1 × 10−6; −0.12 [−0.20, −0.05], P = 1.6 × 10−3), in addition to clinical covariates. Final eGFR was negatively associated with osteopontin (−0.21 [−0.28, −0.14], P = 2.3 × 10−8) and cystatin C (−0.16 [−0.22, −0.09], P = 1.6 × 10−6). Rapid decliner phenotype was associated with osteopontin (OR: 1.83 [1.42, 2.41], P = 7.3 × 10−6), whereas rapid increaser phenotype was associated with fibroblast growth factor-23 (FGF-23) (1.59 [1.23, 2.04], P = 2.6 × 10−4). ACR was not associated with any of the biomarkers. In the adult cohort similar associations with eGFR were found; however, several additional biomarkers were associated with eGFR and ACR. 

    Conclusions: In this young population with T1D and high rates of hyperfiltration, osteopontin was the most consistent biomarker associated with prospective changes in eGFR. FGF-23 was associated with eGFR increases, whereas trefoil factor-3, cystatin C, and B2M were associated with baseline eGFR.

    Original languageEnglish
    Pages (from-to)1322-1332
    Number of pages11
    JournalPediatric Diabetes
    Volume21
    Issue number7
    Early online date17 Aug 2020
    DOIs
    Publication statusPublished - Nov 2022

    UN SDGs

    This output contributes to the following UN Sustainable Development Goals (SDGs)

    1. SDG 3 - Good Health and Well-being
      SDG 3 Good Health and Well-being

    Keywords

    • adolescents
    • biomarkers
    • complications
    • GFR
    • kidney disease

    ASJC Scopus subject areas

    • Internal Medicine
    • Pediatrics, Perinatology, and Child Health
    • Endocrinology, Diabetes and Metabolism

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