18.05.2019 | Original article
E-cadherin and periostin in early detection and progression of diabetic nephropathy: epithelial-to-mesenchymal transition
verfasst von:
Nada M. Qamar El-Dawla, Al-Aliaa M. Sallam, Mohamed H. El-Hefnawy, Hala O. El-Mesallamy
Erschienen in:
Clinical and Experimental Nephrology
|
Ausgabe 8/2019
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Abstract
Background
Diabetic nephropathy (DN) is a severe complication of diabetes mellitus (DM). Many mechanisms are involved in its development; one of these mechanisms is epithelial-to-mesenchymal transition (EMT). During EMT, losing of the epithelial biomarkers like E-cadherin and increasing of mesenchymal biomarkers like periostin are very characteristic.
Methods
The study included 19 healthy controls and 71 DN patients categorized according to their urinary albumin-to-creatinine ratio (UACR) into 19 normoalbuminuric (UACR < 30 mg/g), 37 microalbuminuric (UACR 30–300 mg/g), and 15 macroalbuminuric (UACR > 300 mg/g) patients. Fasting plasma glucose (FPG), glycated hemoglobin (HbA1C%), serum creatinine (Cr), and urea were measured. E-cadherin and periostin were measured by ELISA and compared among groups.
Results
Concerning E-cadherin levels, in comparison to control group, there were significantly decreased in all groups (0.94, 0.52, and 0.14 ng/mL in normoalbuminuria, microalbuminuria, and macroalbuminuria groups; respectively). For periostin levels, nonsignificant increase in normoalbuminuria (0.32 ng/mL) than control group (0.3 ng/mL) was observed. There was a significant increase in other groups with the highest values in macroalbuminuria group (1.66 ng/mL). E-cadherin and periostin were correlated with each other (r = − 0.353, P < 0.001). UACR was negatively correlated with E-cadherin and positively correlated with periostin. ROC curve analyses showed that the AUC to diagnose established microalbuminuria using E-cadherin was 0.998 (95% CI 0. 932–1), and using periostin was 0.833 (95% CI 0.709–0.919).
Conclusion
Serum E-cadherin and periostin could be considered as reliable biomarkers involved in DN pathogenesis and linked to its stages.