Urine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study

Abstract Background Albumin, along with other proteins, is abnormally eliminated via the urine during early stages of diabetic nephropathy. Moreover, endothelial dysfunction (ED) accompanying early diabetic nephropathy may develop even before microalbuminuria is detectable. Transferrin has a molecul...

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Autores principales:	José Juan Sánchez-Hidalgo, Juan Antonio Suárez-Cuenca, José Juan Lozano-Nuevo, Víctor Hugo García-López, María Graciela Leal-Gutiérrez, Sein Antonio León-Angel, María Leslye Ramírez-Villa, Martha Elena Rodea-Rubio, José Enrique González-Hernández, José Antonio Canela-Mayoral, Eduardo Murillo-Heredia, Eduardo Vera-Gómez, Alejandro Hernández-Patricio, Carlos Ramiro Zamora-Alemán, Gabriela Alexandra Domínguez-Pérez, Juan Ariel Gutiérrez-Buendia, Paul Mondragón-Terán
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Urinary transferrin Chronic kidney disease Type 2 Diabetes mellitus Carotid intima-media thickness Endothelial dysfunction Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/53af0268d6614693bfc15f3be07cdef9
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spelling	oai:doaj.org-article:53af0268d6614693bfc15f3be07cdef92021-11-14T12:38:50ZUrine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study10.1186/s13098-021-00745-11758-5996https://doaj.org/article/53af0268d6614693bfc15f3be07cdef92021-11-01T00:00:00Zhttps://doi.org/10.1186/s13098-021-00745-1https://doaj.org/toc/1758-5996Abstract Background Albumin, along with other proteins, is abnormally eliminated via the urine during early stages of diabetic nephropathy. Moreover, endothelial dysfunction (ED) accompanying early diabetic nephropathy may develop even before microalbuminuria is detectable. Transferrin has a molecular weight comparable to albumin, whereas transferrinuria and microalbuminuria in a 24-h urine sample may comparably reflect early diabetic nephropathy. Whereas transferrin metabolism is related with ED during very early diabetic nephropathy has not been elucidated yet. This case–control study aimed to evaluate the relation between ED and urine transferrin, even before early diabetic nephropathy is present. Methods Patients were enrolled from two study sites in Mexico City: Ticomán General Hospital (healthy controls); and a Specialized Clinic for the Management of the Diabetic Patient (cases). All patients provided written informed consent. The primary endpoint was the correlation between urinary transferrin concentration and ED measured in type 2 diabetic patients without albuminuria. ED was evaluated by ultrasonographic validated measurements, which included carotid intima-media thickness (CIMT) and flow mediated dilation (FMD). Plasma biomarkers included glycated hemoglobin, creatinine, cholesterol and triglycerides, as well as urine albumin, transferrin and evidence of urinary tract infection. Results Sixty patients with type 2 Diabetes Mellitus (t2DM; n = 30) or without t2DM (n = 30), both negative for microalbuminuria, were recruited. The group with t2DM were older, with higher values of HbA1c and higher ED. This group also showed significant differences in urine transferrin and urine/plasma transferrin ratio, as compared with healthy controls (14.4 vs. 18.7 mg/mL, p = 0.04, and 74.2 vs. 49.5; p = 0.01; respectively). Moreover, urine transferrin correlated with higher CIMT values (r = 0.37, p = 0.04), being particularly significant for t2DM population. CIMT also correlated with time from t2DM diagnosis (r = 0.48, p < 0.001) and HbA1c (r = 0.48; p < 0.001). Conclusion Urine transferrin correlated with subclinical atherogenesis in patients with t2DM without renal failure, suggesting its potential to identify cardiovascular risk in patients at very early nephropathy stage without microalbuminuria.José Juan Sánchez-HidalgoJuan Antonio Suárez-CuencaJosé Juan Lozano-NuevoVíctor Hugo García-LópezMaría Graciela Leal-GutiérrezSein Antonio León-AngelMaría Leslye Ramírez-VillaMartha Elena Rodea-RubioJosé Enrique González-HernándezJosé Antonio Canela-MayoralEduardo Murillo-HerediaEduardo Vera-GómezAlejandro Hernández-PatricioCarlos Ramiro Zamora-AlemánGabriela Alexandra Domínguez-PérezJuan Ariel Gutiérrez-BuendiaPaul Mondragón-TeránBMCarticleUrinary transferrinChronic kidney diseaseType 2 Diabetes mellitusCarotid intima-media thicknessEndothelial dysfunctionNutritional diseases. Deficiency diseasesRC620-627ENDiabetology & Metabolic Syndrome, Vol 13, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Urinary transferrin Chronic kidney disease Type 2 Diabetes mellitus Carotid intima-media thickness Endothelial dysfunction Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	Urinary transferrin Chronic kidney disease Type 2 Diabetes mellitus Carotid intima-media thickness Endothelial dysfunction Nutritional diseases. Deficiency diseases RC620-627 José Juan Sánchez-Hidalgo Juan Antonio Suárez-Cuenca José Juan Lozano-Nuevo Víctor Hugo García-López María Graciela Leal-Gutiérrez Sein Antonio León-Angel María Leslye Ramírez-Villa Martha Elena Rodea-Rubio José Enrique González-Hernández José Antonio Canela-Mayoral Eduardo Murillo-Heredia Eduardo Vera-Gómez Alejandro Hernández-Patricio Carlos Ramiro Zamora-Alemán Gabriela Alexandra Domínguez-Pérez Juan Ariel Gutiérrez-Buendia Paul Mondragón-Terán Urine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study
description	Abstract Background Albumin, along with other proteins, is abnormally eliminated via the urine during early stages of diabetic nephropathy. Moreover, endothelial dysfunction (ED) accompanying early diabetic nephropathy may develop even before microalbuminuria is detectable. Transferrin has a molecular weight comparable to albumin, whereas transferrinuria and microalbuminuria in a 24-h urine sample may comparably reflect early diabetic nephropathy. Whereas transferrin metabolism is related with ED during very early diabetic nephropathy has not been elucidated yet. This case–control study aimed to evaluate the relation between ED and urine transferrin, even before early diabetic nephropathy is present. Methods Patients were enrolled from two study sites in Mexico City: Ticomán General Hospital (healthy controls); and a Specialized Clinic for the Management of the Diabetic Patient (cases). All patients provided written informed consent. The primary endpoint was the correlation between urinary transferrin concentration and ED measured in type 2 diabetic patients without albuminuria. ED was evaluated by ultrasonographic validated measurements, which included carotid intima-media thickness (CIMT) and flow mediated dilation (FMD). Plasma biomarkers included glycated hemoglobin, creatinine, cholesterol and triglycerides, as well as urine albumin, transferrin and evidence of urinary tract infection. Results Sixty patients with type 2 Diabetes Mellitus (t2DM; n = 30) or without t2DM (n = 30), both negative for microalbuminuria, were recruited. The group with t2DM were older, with higher values of HbA1c and higher ED. This group also showed significant differences in urine transferrin and urine/plasma transferrin ratio, as compared with healthy controls (14.4 vs. 18.7 mg/mL, p = 0.04, and 74.2 vs. 49.5; p = 0.01; respectively). Moreover, urine transferrin correlated with higher CIMT values (r = 0.37, p = 0.04), being particularly significant for t2DM population. CIMT also correlated with time from t2DM diagnosis (r = 0.48, p < 0.001) and HbA1c (r = 0.48; p < 0.001). Conclusion Urine transferrin correlated with subclinical atherogenesis in patients with t2DM without renal failure, suggesting its potential to identify cardiovascular risk in patients at very early nephropathy stage without microalbuminuria.
format	article
author	José Juan Sánchez-Hidalgo Juan Antonio Suárez-Cuenca José Juan Lozano-Nuevo Víctor Hugo García-López María Graciela Leal-Gutiérrez Sein Antonio León-Angel María Leslye Ramírez-Villa Martha Elena Rodea-Rubio José Enrique González-Hernández José Antonio Canela-Mayoral Eduardo Murillo-Heredia Eduardo Vera-Gómez Alejandro Hernández-Patricio Carlos Ramiro Zamora-Alemán Gabriela Alexandra Domínguez-Pérez Juan Ariel Gutiérrez-Buendia Paul Mondragón-Terán
author_facet	José Juan Sánchez-Hidalgo Juan Antonio Suárez-Cuenca José Juan Lozano-Nuevo Víctor Hugo García-López María Graciela Leal-Gutiérrez Sein Antonio León-Angel María Leslye Ramírez-Villa Martha Elena Rodea-Rubio José Enrique González-Hernández José Antonio Canela-Mayoral Eduardo Murillo-Heredia Eduardo Vera-Gómez Alejandro Hernández-Patricio Carlos Ramiro Zamora-Alemán Gabriela Alexandra Domínguez-Pérez Juan Ariel Gutiérrez-Buendia Paul Mondragón-Terán
author_sort	José Juan Sánchez-Hidalgo
title	Urine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study
title_short	Urine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study
title_full	Urine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study
title_fullStr	Urine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study
title_full_unstemmed	Urine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study
title_sort	urine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/53af0268d6614693bfc15f3be07cdef9
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Urine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study

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