Association of serum levels of secreted frizzled-related protein 5 and Wnt member 5a with glomerular filtration rate in patients with type 2 diabetes mellitus and chronic renal disease: a cross-sectional study

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ABSTRACT

BACKGROUND:

Diabetic nephropathy is a common complication of chronic kidney disease (CKD). Inflammation in the kidneys is crucial for promoting development and progression of this complication. Wnt member 5a (Wnt5a) and secreted frizzled-related protein 5 (Sfrp5) are proinflammatory proteins associated with insulin resistance and chronic low-grade adipose tissue inflammation.

OBJECTIVE:

To determine the correlation between serum Sfrp5 and Wnt5a concentrations and glomerular filtration rate in patients with type 2 diabetes mellitus and CKD.

DESIGN AND SETTING:

Cross-sectional, comparative and observational study in the Department of Endocrinology, Civil Hospital, Culiacán, Sinaloa, Mexico.

METHODS:

Eighty individuals with chronic kidney disease were recruited. Their serum Sfrp5 and Wnt5a concentrations were quantified using the enzyme-linked immunosorbent assay (ELISA) test. The statistical analysis consisted of the Mann-Whitney U test for independent samples and Spearman correlation, with statistical significance of P < 0.05.

RESULTS:

Serum Sfrp5 concentration continually increased through the stages of CKD progression, whereas serum Wnt5a concentration presented its highest levels in stage 3 CKD. Negative correlations between estimated glomerular filtration rate (eGFR) and serum concentrations of Sfrp5 (r = -0434, P = 0.001) and Wnt5a (r = -0481, P = 0.001) were found.

CONCLUSIONS:

There were negative correlations between serum Sfrp5 and Wnt5a concentrations and eGFR at each stage of CKD, with higher levels in female patients. This phenomenon suggests that Sfrp5 and Wnt5a might be involved in development and evolution towards end-stage renal disease.

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Most cited references 28

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Inflammation in Diabetic Nephropathy

Andy K. H. Lim, Gregory Tesch (2012)

Diabetic nephropathy is the leading cause of end-stage kidney disease worldwide but current treatments remain suboptimal. This review examines the evidence for inflammation in the development and progression of diabetic nephropathy in both experimental and human diabetes, and provides an update on recent novel experimental approaches targeting inflammation and the lessons we have learned from these approaches. We highlight the important role of inflammatory cells in the kidney, particularly infiltrating macrophages, T-lymphocytes and the subpopulation of regulatory T cells. The possible link between immune deposition and diabetic nephropathy is explored, along with the recently described immune complexes of anti-oxidized low-density lipoproteins. We also briefly discuss some of the major inflammatory cytokines involved in the pathogenesis of diabetic nephropathy, including the role of adipokines. Lastly, we present the latest data on the pathogenic role of the stress-activated protein kinases in diabetic nephropathy, from studies on the p38 mitogen activated protein kinase and the c-Jun amino terminal kinase cell signalling pathways. The genetic and pharmacological approaches which reduce inflammation in diabetic nephropathy have not only enhanced our understanding of the pathophysiology of the disease but shown promise as potential therapeutic strategies.

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Immunity and inflammation in diabetic kidney disease: translating mechanisms to biomarkers and treatment targets.

Raimund Pichler, Maryam Afkarian, Brad P. Dieter … (2017)

Increasing incidences of obesity and diabetes have made diabetic kidney disease (DKD) the leading cause of chronic kidney disease and end-stage renal disease worldwide. Despite current pharmacological treatments, including strategies for optimizing glycemic control and inhibitors of the renin-angiotensin system, DKD still makes up almost one-half of all cases of end-stage renal disease in the United States. Compelling and mounting evidence has clearly demonstrated that immunity and inflammation play a paramount role in the pathogenesis of DKD. This article reviews the involvement of the immune system in DKD and identifies important roles of key immune and inflammatory mediators. One of the most recently identified biomarkers is serum amyloid A, which appears to be relatively specific for DKD. Novel and evolving treatment approaches target protein kinases, transcription factors, chemokines, adhesion molecules, growth factors, advanced glycation end-products, and other inflammatory molecules. This is the beginning of a new era in the understanding and treatment of DKD, and we may have finally reached a tipping point in our fight against the growing burden of DKD.

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Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.

David Sacks, Mark Arnold, George L. Bakris … (2011)

Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence Based Laboratory Medicine Committee of the AACC jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A(1c) (Hb A(1c)) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of Hb A(1c). The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

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Author and article information

Contributors

Indira Rojo Báez: Role: made substantial contributions to drafting the article;

Daniel Omar Rivera Castro: Role: made substantial contributions to collected the data, analyzed and interpreted the data for the work;

Sarahí Salas Gutiérrez: Role: made substantial contributions to collected the data, analyzed and interpreted the data for the work;

Edgar Dehesa López: Role: made substantial contributions to the design and analysis of the study, interpreting the data, and helped in revising the article;

Adriana Aguilar Lemarroy: Role: made substantial contributions to the design and analysis of the study, interpreting the data, and helped in revising the article;

Luis Felipe Jave Suarez: Role: made substantial contributions to the design and analysis of the study, interpreting the data, and helped in revising the article;

Hipólito Castillo Ureta: Role: made substantial contributions to the design of the study and helped in revising the article;

Edith Hilario Torres Montoya: Role: made substantial contributions to the design of the study and helped in revising the article;

Vicente Olimón Andalón: Role: made substantial contributions to the conception, design and analysis of the study and in interpreting the data, and helped in drafting and revising the article.

Journal

Journal ID (nlm-ta): Sao Paulo Med J

Journal ID (iso-abbrev): Sao Paulo Med J

Journal ID (publisher-id): Sao Paulo Med J

Title: São Paulo Medical Journal

Publisher: Associação Paulista de Medicina - APM

ISSN (Print): 1516-3180

ISSN (Electronic): 1806-9460

Publication date (Electronic): 01 June 2020

Publication date Collection: 2020

Volume: 138

Issue: 2

Pages: 133-139

Affiliations

[I ] originalPhD. Professor, Department of Immunogenetics, Facultad de Biología, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México.

[II ] originalBSc. Biologist, Facultad de Biología, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México.

[III ] originalBSc. Biologist, Facultad de Biología, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México.

[IV ] originalMD. Research Investigator, Centro de Investigación y Docencia en Ciencias de la Salud, Culiacán, Sinaloa, México.

[V ] originalPhD. Research Investigator, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Culiacán, Sinaloa, México.

[VI ] originalPhD. Research Investigator, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Culiacán, Sinaloa, México.

[VII ] originalPhD. Research Investigator, Facultad de Biología, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México.

[VIII ] originalPhD. Research Investigator, Facultad de Biología, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México.

[IX ] originalPhD. Research Investigator, Facultad de Biología, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México.

Author notes

Address for correspondence: Vicente Olimón Andalón. Calle Arnulfo Rodríguez No. 84, Colonia Vicente Lombardo Toledano, C.P. 80010, Culiacán, Sinaloa, Mexico. Tel. (667) 4555144; (667) 1840256. E-mail: voauas@ 123456uas.edu.mx

Authors’ contributions: All the authors approved the version to be published and gave their agreement to be responsible for all aspects of the work, so as to ensure that questions relating to the accuracy or integrity of all the work are appropriately investigated and resolved

Conflict of interest: None

Article

DOI: 10.1590/1516-3180.2019.0304.R2.09122019

PMC ID: 9662847

PubMed ID: 32491086

SO-VID: 441af10e-415b-4b3f-a287-e677441a00f3

License:

This is an open access article distributed under the terms of the Creative Commons license.

History

Date revision received : 20 July 2019

Date received : 15 November 2019

Date accepted : 09 December 2019

Page count

Figures: 4, Tables: 1, Equations: 0, References: 27, Pages: 07

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Association of serum levels of secreted frizzled-related protein 5 and Wnt member 5a with glomerular filtration rate in patients with type 2 diabetes mellitus and chronic renal disease: a cross-sectional study

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ABSTRACT

BACKGROUND:

OBJECTIVE:

DESIGN AND SETTING:

METHODS:

RESULTS:

CONCLUSIONS:

Related collections

SciELO Brazil

Most cited references 28

Inflammation in Diabetic Nephropathy

Immunity and inflammation in diabetic kidney disease: translating mechanisms to biomarkers and treatment targets.

Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.

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Cited by 2

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