Markers of endothelial dysfunction and inflammation predict progression of diabetic nephropathy in African Americans with type 1 diabetes

• Published in: Kidney international Vol. 87; no. 2; pp. 427 - 433
• Main Authors: Roy, Monique S., Janal, Malvin N., Crosby, Juan, Donnelly, Robert
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2015; Elsevier Limited
• Subjects: Adolescent; Adult; African Americans; Biomarkers - blood; chemokine; chronic kidney disease; chronic renal failure; Cohort Studies; cytokines; Cytokines - blood; diabetes mellitus; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - physiopathology; Diabetic Nephropathies - physiopathology; diabetic nephropathy; Disease Progression; Female; Follow-Up Studies; Humans; Inflammation Mediators - blood; Intercellular Adhesion Molecule-1 - blood; Male; Middle Aged; Proteinuria - physiopathology; Young Adult; chemokine; chronic kidney disease; cytokines; diabetes mellitus; chronic renal failure; diabetic nephropathy
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/ki.2014.212

African Americans with early-onset type 1 diabetes mellitus are at a high risk for severe diabetic nephropathy and end-stage renal disease. In order to determine whether baseline plasma levels of inflammatory markers predict incidence of overt proteinuria or renal failure in African Americans with type 1 diabetes mellitus, we re-examined data of 356 participants in our observational follow-up study of 725 New Jersey African Americans with type 1 diabetes. At baseline and 6-year follow-up, a detailed structured clinical interview was conducted to document medical history including kidney dialysis or transplant, other diabetic complications, and renal-specific mortality. Plasma levels of 28 inflammatory biomarkers were measured using a multiplex bead analysis system. After adjusting for baseline age, glycohemoglobin, and other confounders, the baseline plasma levels of soluble intercellular adhesion molecule-1 (sICAM-1) in the upper two quartiles were, respectively, associated with a three- to fivefold increase in the risk of progression from no albuminuria or microalbuminuria to overt proteinuria. Baseline plasma levels of the chemokine eotaxin in the upper quartile were significantly associated with a sevenfold increase in risk of incident renal failure. These associations were independent of traditional risk factors for progression of diabetic nephropathy. Thus, in type 1 diabetic African Americans, sICAM-1 predicted progression to overt proteinuria and eotaxin-predicted progression to renal failure.