Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr;55(4):1001-1013.
doi: 10.1007/s11255-022-03326-x. Epub 2022 Oct 18.

Urine metabolomics reveals biomarkers and the underlying pathogenesis of diabetic kidney disease

Affiliations

Urine metabolomics reveals biomarkers and the underlying pathogenesis of diabetic kidney disease

Maolin Luo et al. Int Urol Nephrol. 2023 Apr.

Abstract

Purpose: Diabetic kidney disease (DKD) is the most common complication of type 2 diabetes mellitus (T2DM), and its pathogenesis is not yet fully understood and lacks noninvasive and effective diagnostic biomarkers. In this study, we performed urine metabolomics to identify biomarkers for DKD and to clarify the potential mechanisms associated with disease progression.

Methods: We applied a liquid chromatography-mass spectrometry-based metabolomics method combined with bioinformatics analysis to investigate the urine metabolism characteristics of 79 participants, including healthy subjects (n = 20), T2DM patients (n = 20), 39 DKD patients that included 19 DKD with microalbuminuria (DKD + micro) and 20 DKD with macroalbuminuria (DKD + macro).

Results: Seventeen metabolites were identified between T2DM and DKD that were involved in amino acid, purine, nucleotide and primarily bile acid metabolism. Ultimately, a combined model consisting of 2 metabolites (tyramine and phenylalanylproline) was established, which had optimal diagnostic performance (area under the curve (AUC) = 0.94). We also identified 19 metabolites that were co-expressed within the DKD groups and 41 metabolites specifically expressed in the DKD + macro group. Ingenuity pathway analysis revealed three interaction networks of these 60 metabolites, involving the sirtuin signaling pathway and ferroptosis signaling pathway, as well as the downregulation of organic anion transporter 1, which may be important mechanisms that mediate the progression of DKD.

Conclusions: This work reveals the metabolic alterations in T2DM and DKD, constructs a combined model to distinguish them and delivers a novel strategy for studying the underlying mechanism and treatment of DKD.

Keywords: Diabetic kidney disease; Ferroptosis; Ingenuity pathway analysis; Metabolomics; OAT1; Sirtuin signaling.

PubMed Disclaimer

References

    1. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, Colagiuri S, Guariguata L, Motala AA, Ogurtsova K, Shaw JE, Bright D, Williams R, Committee IDFDA (2019) Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the international diabetes federation diabetes atlas, 9(th) edition. Diabetes Res Clin Pract 157:107843. https://doi.org/10.1016/j.diabres.2019.107843 - DOI - PubMed
    1. Akin S, Boluk C (2020) Prevalence of comorbidities in patients with type-2 diabetes mellitus. Prim Care Diabetes 14:431–434. https://doi.org/10.1016/j.pcd.2019.12.006 - DOI - PubMed
    1. Bhensdadia NM, Hunt KJ, Lopes-Virella MF, Michael Tucker J, Mataria MR, Alge JL, Neely BA, Janech MG, Arthur JM, Veterans Affairs Diabetes Trial study g (2013) Urine haptoglobin levels predict early renal functional decline in patients with type 2 diabetes. Kidney Int 83:1136-1143. https://doi.org/10.1038/ki.2013.57
    1. Halimi JM (2012) The emerging concept of chronic kidney disease without clinical proteinuria in diabetic patients. Diabetes Metab 38:291–297. https://doi.org/10.1016/j.diabet.2012.04.001 - DOI - PubMed
    1. Macisaac RJ, Jerums G (2011) Diabetic kidney disease with and without albuminuria. Curr Opin Nephrol Hypertens 20:246–257. https://doi.org/10.1097/MNH.0b013e3283456546 - DOI - PubMed

LinkOut - more resources