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. 2024 Aug 6;10(16):e35635.
doi: 10.1016/j.heliyon.2024.e35635. eCollection 2024 Aug 30.

Association between lipoprotein-associated phospholipase A2 and 25-hydroxy-vitamin D on early stage diabetic kidney disease in patients with type-2 diabetes mellitus

Zheng Zhang  1   2 , Xiang Qian  1   2 , Ziwei Sun  1   2 , Chen Cheng  1   2 , Min Gu  1   2
Affiliations

Association between lipoprotein-associated phospholipase A2 and 25-hydroxy-vitamin D on early stage diabetic kidney disease in patients with type-2 diabetes mellitus

Zheng Zhang et al. Heliyon. .

Abstract

Objective: This study aimed to analyse the association between lipoprotein-associated phospholipase A2 (Lp-PLA2) and 25-hydroxy-vitamin D (25[OH]D) and early diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM) and evaluate the potential roles of these two biomarkers in the clinical diagnosis of DKD.

Methods: A total of 422 inpatients with T2DM were retrospectively enrolled between January 2018 and March 2022 at the First Affiliated Hospital of Nanjing Medical University. The baseline clinical parameters of each patient were determined, and their demographic characteristics were extracted from the hospital information system. The patients were separated into groups according to serum Lp-PLA2 and 25(OH)D levels and binary logistic regression analysis was used to determine independent predictors of early DKD incidence.

Results: Levels of Lp-PLA2 significantly increased and those of 25(OH)D significantly decreased with DKD progression (both P < 0.001). Lp-PLA2 concentrations were positively correlated with albuminuria levels (r = 0.37, P < 0.001), whereas 25(OH)D levels were negatively correlation (r = -0.34, P < 0.001). The incidence of DKD was higher in the Lp-PLA2 elevated and 25(OH)D deficient groups (all P < 0.001). Body mass index, systemic immune-inflammatory index, serum uric acid, C-peptide, and triglyceride-glucose indices were positively associated with Lp-PLA2 levels (all P < 0.001) and negatively associated with 25(OH)D (all P < 0.05). Furthermore, Lp-PLA2 was an independent risk factor (OR = 1.003, P = 0.015), and 25(OH)D was an independent protective factor (OR = 0.937, P = 0.008) for early DKD occurrence in binary logistic regression analysis. The area under the curve for the combination of Lp-PLA2 and 25(OH)D for diagnosing DKD was 0.867, with a sensitivity of 70.4 % and a specificity of 89.5 %.

Conclusions: Increased serum Lp-PLA2 and decreased 25(OH)D levels are risk factors for early DKD in patients with T2DM. The combined detection of Lp-PLA2 and 25(OH)D may enhance the diagnostic efficacy of DKD.

Keywords: 25-Hydroxy-vitamin D; Early diabetic kidney disease; Lipoprotein-associated phospholipase A2; Type 2 diabetes mellitus; Urine albumin excretion rate.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flow diagram illustrates exclusion criteria and final study population.
Fig. 2
Fig. 2
Status of different Lp-PLA2 (A) and 25(OH)D (B) circulating levels in patients with T2DM. Abbreviations: Lp-PLA2, lipoprotein-associated phospholipase A2; 25(OH)D, 25-hydroxy-vitamin D; T2DM, type 2 diabetes mellitus; NS, not significant.
Fig. 3
Fig. 3
Correlation analysis of Lp-PLA2 (A) and 25(OH)D (B) with albuminuria, and between Lp-PLA2 and 25(OH)D (C). Abbreviations: Lp-PLA2, lipoprotein-associated phospholipase A2; 25(OH)D, 25-hydroxy-vitamin D.
Fig. 4
Fig. 4
Lp-PLA2 (A) and 25(OH)D (B) levels in different eGFR subgroups. Abbreviations: Lp-PLA2, lipoprotein-associated phospholipase A2; 25(OH)D, 25-hydroxy-vitamin D; eGFR, estimated glomerular filtration rate.
Fig. 5
Fig. 5
ROC curves of Lp-PLA2 and 25(OH)D in the diagnosis of DKD. Abbreviations: DKD, diabetic kidney disease; Lp-PLA2, lipoprotein-associated phospholipase A2; 25(OH)D, 25-hydroxy-vitamin D; ROC, receiver operating characteristic.
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References

    1. Yosri H., et al. Calycosin modulates NLRP3 and TXNIP-mediated pyroptotic signaling and attenuates diabetic nephropathy progression in diabetic rats; an insight. Biomed. Pharmacother. 2022;155 doi: 10.1016/j.biopha.2022.113758. - DOI - PubMed
    1. Chen D.Q., Wu J., Li P. Therapeutic mechanism and clinical application of Chinese herbal medicine against diabetic kidney disease. Front. Pharmacol. 2022;13 doi: 10.3389/fphar.2022.1055296. - DOI - PMC - PubMed
    1. Kikuchi K., et al. Gut microbiome-derived phenyl sulfate contributes to albuminuria in diabetic kidney disease. Nat. Commun. 2019;10(1):1835. doi: 10.1038/s41467-019-09735-4. - DOI - PMC - PubMed
    1. Xing C., et al. The predictive value of miR-377 and phospholipase A2 in the early diagnosis of diabetic kidney disease and their relationship with inflammatory factors. Immunobiology. 2024;229(2) doi: 10.1016/j.imbio.2024.152792. - DOI - PubMed
    1. Comai G., et al. Histological evidence of diabetic kidney disease precede clinical diagnosis. Am. J. Nephrol. 2019;50(1):29–36. doi: 10.1159/000500353. - DOI - PMC - PubMed

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