Could serum zonulin be an intestinal permeability marker in diabetes kidney disease?

Zonulin is a protein associated with the tight junction complex opening at the intestinal epithelium, previously linked to obesity, cardiovascular diseases, type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). However, its role in CKD has not been totally elucidated. This study aimed to...

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Autores principales:	Larissa Salomoni Carpes, Bruna Bellincanta Nicoletto, Luis Henrique Canani, Jakeline Rheinhemer, Daisy Crispim, Gabriela Corrêa Souza
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ae2e31c81917411caf9904eb37f2d476
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spelling	oai:doaj.org-article:ae2e31c81917411caf9904eb37f2d4762021-12-02T20:09:58ZCould serum zonulin be an intestinal permeability marker in diabetes kidney disease?1932-620310.1371/journal.pone.0253501https://doaj.org/article/ae2e31c81917411caf9904eb37f2d4762021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253501https://doaj.org/toc/1932-6203Zonulin is a protein associated with the tight junction complex opening at the intestinal epithelium, previously linked to obesity, cardiovascular diseases, type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). However, its role in CKD has not been totally elucidated. This study aimed to evaluate zonulin levels in subjects with diabetic kidney disease (DKD). This case-control study included two cases groups: 1) Advanced DKD cases: T2DM patients with estimated glomerular filtration rate (eGFR) <60ml/min/1.73m2; 2) Albuminuric T2DM cases: diabetic patients with urinary albumin excretion (UAE) >30mg/g creatinine, but with eGFR>60ml/min/1.73m2. Two control groups were also included: 1) T2DM controls: patients with T2DM without impaired kidney function; 2) Non-T2DM controls: subjects without T2DM and normal renal function. Serum levels of zonulin were measured by ELISA. Eighty-six individuals were included. Zonulin levels was different among study groups (P = 0.003). T2DM controls presented higher zonulin levels than non-T2DM controls [(131.35 (83.0-170.5) vs. 87.25 (54.7-111.8), P = 0.018] and advanced DKD cases [63.72 (45.03-106.0); P = 0.007]. Zonulin showed a positive correlation with eGFR (r = 0.222; P = 0.040), total cholesterol (r = 0.299; P = 0.034), LDL (r = 0.258; P = 0.021), and negative with albuminuria (r = -0.243; P = 0.024) and body fat (r = -0.271; P = 0.014). In the multivariate logistic regression analyses, zonulin levels were independently associated to renal outcomes [OR 0.99 (0.98-0.99, P = 0.012)] after 5-year inclusion. In conclusion, increased zonulin levels in patients with TD2M without renal disease suggest an impaired intestinal permeability. Moreover, its association with renal outcomes could indicate its use as a disease monitoring marker. However, the mechanisms behind this association should be better understood.Larissa Salomoni CarpesBruna Bellincanta NicolettoLuis Henrique CananiJakeline RheinhemerDaisy CrispimGabriela Corrêa SouzaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253501 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Larissa Salomoni Carpes Bruna Bellincanta Nicoletto Luis Henrique Canani Jakeline Rheinhemer Daisy Crispim Gabriela Corrêa Souza Could serum zonulin be an intestinal permeability marker in diabetes kidney disease?
description	Zonulin is a protein associated with the tight junction complex opening at the intestinal epithelium, previously linked to obesity, cardiovascular diseases, type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). However, its role in CKD has not been totally elucidated. This study aimed to evaluate zonulin levels in subjects with diabetic kidney disease (DKD). This case-control study included two cases groups: 1) Advanced DKD cases: T2DM patients with estimated glomerular filtration rate (eGFR) <60ml/min/1.73m2; 2) Albuminuric T2DM cases: diabetic patients with urinary albumin excretion (UAE) >30mg/g creatinine, but with eGFR>60ml/min/1.73m2. Two control groups were also included: 1) T2DM controls: patients with T2DM without impaired kidney function; 2) Non-T2DM controls: subjects without T2DM and normal renal function. Serum levels of zonulin were measured by ELISA. Eighty-six individuals were included. Zonulin levels was different among study groups (P = 0.003). T2DM controls presented higher zonulin levels than non-T2DM controls [(131.35 (83.0-170.5) vs. 87.25 (54.7-111.8), P = 0.018] and advanced DKD cases [63.72 (45.03-106.0); P = 0.007]. Zonulin showed a positive correlation with eGFR (r = 0.222; P = 0.040), total cholesterol (r = 0.299; P = 0.034), LDL (r = 0.258; P = 0.021), and negative with albuminuria (r = -0.243; P = 0.024) and body fat (r = -0.271; P = 0.014). In the multivariate logistic regression analyses, zonulin levels were independently associated to renal outcomes [OR 0.99 (0.98-0.99, P = 0.012)] after 5-year inclusion. In conclusion, increased zonulin levels in patients with TD2M without renal disease suggest an impaired intestinal permeability. Moreover, its association with renal outcomes could indicate its use as a disease monitoring marker. However, the mechanisms behind this association should be better understood.
format	article
author	Larissa Salomoni Carpes Bruna Bellincanta Nicoletto Luis Henrique Canani Jakeline Rheinhemer Daisy Crispim Gabriela Corrêa Souza
author_facet	Larissa Salomoni Carpes Bruna Bellincanta Nicoletto Luis Henrique Canani Jakeline Rheinhemer Daisy Crispim Gabriela Corrêa Souza
author_sort	Larissa Salomoni Carpes
title	Could serum zonulin be an intestinal permeability marker in diabetes kidney disease?
title_short	Could serum zonulin be an intestinal permeability marker in diabetes kidney disease?
title_full	Could serum zonulin be an intestinal permeability marker in diabetes kidney disease?
title_fullStr	Could serum zonulin be an intestinal permeability marker in diabetes kidney disease?
title_full_unstemmed	Could serum zonulin be an intestinal permeability marker in diabetes kidney disease?
title_sort	could serum zonulin be an intestinal permeability marker in diabetes kidney disease?
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ae2e31c81917411caf9904eb37f2d476
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Could serum zonulin be an intestinal permeability marker in diabetes kidney disease?

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