Diabetes, Metabolic Syndrome and Obesity (Apr 2021)
Serum Human Epididymis Protein 4 is a Potential Biomarker for Early Chronic Kidney Disease in an Obese Population
Abstract
Shubo Tan, Yongmao Zeng, Shiliang Kuang, Jianjun Li Department of Urology, Second Affiliated Hospital of the University of South China, Hengyang City, 421000, People’s Republic of ChinaCorrespondence: Jianjun LiDepartment of Urology, Second Affiliated Hospital of the University of South China, No. 35, Jiefang Avenue, Zhengxiang District, Hengyang City, 421000, Hunan Province, People’s Republic of ChinaTel +861301734996Email [email protected]: At present, it is difficult to clinically diagnose early chronic kidney disease (CKD). As a novel biomarker of malignancies in the female reproductive tract, the human epididymis protein 4 (HE4) has been reported to be significantly expressed in CKD patients.Aim: We sought to assess whether HE4 can be used as a potential biomarker of early-stage CKD.Methods: The association between serum HE4 levels and CKD was analyzed in a retrospective study. A cohort of 506 patients with diabetic nephropathy who were hospitalized at Weihai Central Hospital, China, from January 2016 to November 2019 were included.Results: Serum HE4 levels were increased with increasing stage of CKD and significantly elevated in patients with CKD3-5 than CKD1-2 (P< 0.001). In multivariate linear regression analyses, HE4 levels were strongly correlated with the estimated glomerular filtration rate (eGFR) in CKD patients (Model 2, P< 0.001). HE4 (area under the curve; AUC=0.934) had better diagnostic value than serum creatinine (SCr; AUC=0.770) and blood urea nitrogen (BUN; AUC=0.647) for patients with early-stage CKD (CKD1-2). Additionally, HE4 levels increased with increasing glomerular lesion (GL) and renal interstitial fibrosis (IF)/tubular atrophy (TA) scores in 51 CKD patients (P< 0.001).Conclusion: Serum HE4 levels can be positively associated with the severity of CKD and are a very valuable clinical biomarker for predicting early-stage CKD.Keywords: biomarker, chronic kidney disease, obese, human epididymis protein 4
