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      Elevated plasma myoglobin level is closely associated with type 2 diabetic kidney disease

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          Abstract

          Background

          Diabetic kidney disease (DKD) is the most frequent complication in patients with type 2 diabetes mellitus (T2DM). It causes a chronic and progressive decline in kidney function, and ultimately patients require renal replacement therapy. To date, an increasing number of clinical studies have been conducted to explore the potential and novel biomarkers, which can advance the diagnosis, estimate the prognosis, and optimize the therapeutic strategies at the early stage of DKD. In the current study, we sought to investigate the association of plasma myoglobin with DKD.

          Methods

          A total of 355 T2DM patients with DKD and 710 T2DM patients without DKD were enrolled in this study. Laboratory parameters including blood cell count, hemoglobin A1c, biochemical parameters, and plasma myoglobin were recorded. Patients were classified on admission according to the tertile of myoglobin and clinical parameters were compared between the groups. Pearson correlation analysis, linear regression, logistic regression, receiver operating characteristics (ROC) analysis, and spline regression were performed.

          Results

          Plasma myoglobin significantly increased in patients with DKD and was associated with renal function and inflammatory parameters. Plasma myoglobin was an independent risk factor for the development of DKD. The area under ROC curve of myoglobin was 0.831. Spline regression showed that there was a significant linear association between DKD incidence and a high level of plasma myoglobin when it exceeded 36.4 mg/mL.

          Conclusions

          This study shows that elevated plasma myoglobin level is closely associated with the development of kidney injury in patients with T2DM.

          Abstract

          Highlights

          • Plasma myoglobin significantly increased in patients with diabetic kidney disease (DKD).

          • Plasma myoglobin was an independent risk factor for DKD.

          • Plasma myoglobin serve as a marker to predict DKD.

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          Most cited references46

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          WITHDRAWN: Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition

          To provide global estimates of diabetes prevalence for 2019 and projections for 2030 and 2045.
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            Diabetic Kidney Disease: Challenges, Progress, and Possibilities.

            Diabetic kidney disease develops in approximately 40% of patients who are diabetic and is the leading cause of CKD worldwide. Although ESRD may be the most recognizable consequence of diabetic kidney disease, the majority of patients actually die from cardiovascular diseases and infections before needing kidney replacement therapy. The natural history of diabetic kidney disease includes glomerular hyperfiltration, progressive albuminuria, declining GFR, and ultimately, ESRD. Metabolic changes associated with diabetes lead to glomerular hypertrophy, glomerulosclerosis, and tubulointerstitial inflammation and fibrosis. Despite current therapies, there is large residual risk of diabetic kidney disease onset and progression. Therefore, widespread innovation is urgently needed to improve health outcomes for patients with diabetic kidney disease. Achieving this goal will require characterization of new biomarkers, designing clinical trials that evaluate clinically pertinent end points, and development of therapeutic agents targeting kidney-specific disease mechanisms (e.g., glomerular hyperfiltration, inflammation, and fibrosis). Additionally, greater attention to dissemination and implementation of best practices is needed in both clinical and community settings.
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              2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018.

              (2017)
              The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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                Author and article information

                Contributors
                xwenjun01@163.com
                heyuan.ding@fudan.edu.cn
                Journal
                J Diabetes
                J Diabetes
                10.1111/(ISSN)1753-0407
                JDB
                Journal of Diabetes
                Wiley Publishing Asia Pty Ltd (Melbourne )
                1753-0393
                1753-0407
                30 November 2023
                March 2024
                : 16
                : 3 ( doiID: 10.1111/jdb.v16.3 )
                : e13508
                Affiliations
                [ 1 ] Department of Nephrology, Shanghai Fifth People's Hospital Fudan University Shanghai China
                [ 2 ] Department of Endocrinology, Shanghai Fifth People's Hospital Fudan University Shanghai China
                [ 3 ] Center of Community‐Based Health Research Fudan University Shanghai China
                [ 4 ] Jiangchuan Community Health Service Center Shanghai China
                [ 5 ] Department of Nephrology Zhejiang Kaihua County Hospital of Chinese Medicine Zhejiang China
                Author notes
                [*] [* ] Correspondence

                Heyuan Ding, Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Road, Minhang District, Shanghai 200240, China.

                Email: heyuan.ding@ 123456fudan.edu.cn

                Wenjun Xu, Department of Nephrology, Zhejiang Kaihua County Hospital of Chinese Medicine, 10 Zhongshan Road, Kaihua County, Zhejiang 324399, China.

                Email: xwenjun01@ 123456163.com

                Author information
                https://orcid.org/0000-0002-1574-8690
                Article
                JDB13508
                10.1111/1753-0407.13508
                10925879
                38036859
                678de2de-025b-438b-81dc-13a35be5cf89
                © 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 October 2023
                : 07 June 2023
                : 12 November 2023
                Page count
                Figures: 7, Tables: 4, Pages: 12, Words: 6271
                Funding
                Funded by: Community Health Research Project of Community Health Research Center of Fudan University
                Award ID: 2020SJ06
                Funded by: Fudan University‐Minhang Health Consortium Cooperation Fund Project
                Award ID: 2022FM01
                Funded by: Kaihua County Doctoral Workstation Fund of Zhejiang Province
                Award ID: 2023KH02
                Funded by: the Science Foundation of Shanghai Fifth People's Hospital
                Award ID: 2018WYZT03
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                March 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.9 mode:remove_FC converted:11.03.2024

                Endocrinology & Diabetes
                glomerular filtration rate,inflammation,nephropathy,oxidative damage,type 2 diabetes

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