Serum Podoplanin Levels as a Potential Biomarker for Diabetic Nephropathy Progression: A Cross-Sectional Study

Abstract

Objective: The study aimed to investigate the impact of serum Podoplanin levels on diabetic nephropathy in patients with type 2 diabetes mellitus (T2DM).

Patients and methods: Between January 2022 and December 2023, the Department of Nephrology at Nantong Second People's Hospital selected 276 patients with T2DM and 150 healthy controls for this investigation. Systematic data collection was performed to gather information on biomarkers and biochemical parameters.

Results: When T2DM patients (n=276) and healthy controls (n=150) were compared, considerably lowered serum Podoplanin levels were observed. In all 276 patients, serum Podoplanin levels were negatively associated with age (r=-0.127, P=0.035), body mass index (BMI) (r=-0.292, P<0.001), duration of diabetes (r=-0.323, P<0.001), systolic blood pressure (SBP) (r=-0.255, P<0.001), diastolic blood pressure (DBP) (r=-0.138, P=0.022), fasting blood glucose (FBG) (r=-0.196, P=0.001), glycated hemoglobin (HbA1c) (r=-0.095, P=0.117), triglyceride (TG) (r=-0.157, P=0.009), total cholesterol (TC) (r=-0.126, P=0.036), low-density lipoprotein cholesterol (LDL-C) (r=-0.187, P=0.002), serum creatinine (Scr) (r=-0.500, P<0.001), neutrophil gelatinase-associated lipocalin (NGAL) (r=-0.339, P<0.001), and kidney injury molecule-1 (KIM-1) (r=-0.568, P<0.001), and was positively correlated with high-density lipoprotein cholesterol (HDL-C) (r=0.343, P<0.001) and estimated glomerular filtration rate (eGFR) (r=0.442, P<0.001). The multivariate logistic regression analysis showed that diabetic patients with DN had lowered levels of serum Podoplanin (OR=0.022, 95% CI=0.005-0.100; P<0.001), lower SBP, Scr, NGAL, and KIM-1.

Conclusion: The results indicated that diabetic patients with DN have lower levels of serum Podoplanin. A more considerable population-based prospective investigation is essential to validate our findings.

Keywords: biomarker; diabetic nephropathy; podoplanin; type 2 diabetes mellitus.

Figure 1

Serum Podoplanin levels in control subjects and T2DM patients. (A) Comparison of serum Podoplanin levels between control subjects and T2DM patients. The serum Podoplanin concentration in T2DM patients (n = 276) was significantly lower than that in control subjects (n = 150). T test was applied. (B) Comparison of serum Podoplanin levels in three subgroups of T2DM patients. ANOVA was applied. ***P<0.001.

Figure 2

The correlation between serum Podoplanin and clinical indicators. Pearson correlation test was performed between Podoplanin with (A) eGFR, (B) Scr, (C) NGAL and (D) KIM-1 in all T2DM patients.

Figure 3

The cut-off value of serum Podoplanin. The ROC curve was used to obtain the optimal cut-off value of serum Podoplanin (3378 ng/mL) that distinguishes the T2DM patients with and without albuminuria.