Diabetes, Metabolic Syndrome and Obesity (Jun 2023)

Potential Role and Expression Level of Urinary CXCL8 in Different Stages of Incipient Diabetic Nephropathy with Undiminished Creatinine Clearance: A Pilot Study

  • He Y,
  • Li H,
  • Wang R,
  • Ma N,
  • Liu L,
  • Shi R,
  • Zhang B,
  • Lin N,
  • Tian Y

Journal volume & issue
Vol. Volume 16
pp. 1783 – 1790

Abstract

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Yang He,1 Huili Li,2 Rui Wang,3 Ning Ma,3 Lianyuan Liu,4 Rui Shi,5 Bohua Zhang,3 Ningning Lin,6 Yiming Tian3 1Hemodialysis Room, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, People’s Republic of China; 2Department of Endocrinology, The First Hospital of Qinhuangdao Affiliated to Hebei Medical University, Qinhuangdao, 066000, People’s Republic of China; 3Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, People’s Republic of China; 4Functional Examination Department, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, People’s Republic of China; 5Rheumatology and Immunology Department, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, People’s Republic of China; 6Department of Dermatology, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, People’s Republic of ChinaCorrespondence: Yiming Tian, Department of Endocrinology, The First Hospital of Qinhuangdao, No. 258, Wenhua Road, Qinhuangdao, Hebei Province, 066000, People’s Republic of China, Email [email protected]: Diabetic nephropathy (DN) is one of the most devastating microvascular complications of diabetes, with a high prevalence and poor prognosis. Early intervention is crucial to improve the outcomes of DN. CXCL8 is related to podocyte damage in incipient DN; however, the role and expression level of CXCL8 have never been elucidated, especially in those with undiminished creatinine clearance.Methods: Consecutive inpatients with type 2 diabetes were included in this study. Patients were assigned into four groups based on the Mogensen stage, reflecting pathological features through clinical manifestations: non-DN group, hyperfiltration group, microalbuminuria group and overt DN group. Clinical and laboratory data were retrospectively collected and analyzed. Urinary CXCL8 (uCXCL8) was measured using an enzyme-linked immunosorbent assay (ELISA) method and adjusted for urinary creatinine (Cr) from the same urine sample.Results: In total, 88 eligible consecutive inpatients with type 2 diabetes were included in this study. uCXCL8 was differentially expressed in different stages of incipient DN; it decreased in the hyperfiltration phase of incipient DN (1.40± 1.01 pg/μmol Cr) and was highly expressed in patients in the microalbuminuria stage (5.01± 4.01 pg/μmol Cr). uCXCL8 was positively correlated with age, diabetes course, cystatin C and urinary albuminuria-to-creatinine ratio, but negatively correlated with estimated glomerular filtration rate (P< 0.05). uCXCL8 was a risk factor for classic DN after adjusting for age, diabetes course and cystatin C (OR= 1.17, 95% CI 0.98– 1.4, P=0.045).Conclusion: CXCL8 played an important role in the progression of incipient DN. The unique expression profile of uCXCL8 may provide a reference for understanding the prognosis and mechanisms of incipient DN progression. uCXCL8 was an independent risk factor for the development of classic DN.Keywords: type 2 diabetes, diabetic nephropathies, interleukin-8, inflammation

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