(12-05-12) Urinary markers of renal inflammation in adolescents with Type1 diabetes mellitus and normoalbuminuria.

Cherney DZ,?Scholey JW,?Daneman D,?Dunger DB,?Dalton RN,?Moineddin R,?Mahmud F,?Dekker R,?Elia Y,?Sochett E,?Reich HN.
Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto Department of Pediatrics, Division of Endocrinology, The Hospital for Sick Children, University of Toronto, ON, Canada Department of Pediatrics, University of Cambridge, Cambridge WellChild Laboratory, Evelina Children's Hospital, St Thomas' Hospital, London, UK Department of Family and Community Medicine, University of Toronto, ON, Canada.
Abstract
Objective:  Patients with the highest albumin:creatinine ratio within the normal range are at an increased risk for developing microalbuminuria. The mechanistic basis for this is unknown, but may be related to renal inflammation. Our goal was to characterize the urinary excretion of cytokines/chemokines in normoalbuminuric adolescents with Type 1 diabetes to determine whether higher range normoalbuminuria is associated with evidence of renal inflammation. Research design:  Forty-two urinary cytokines/chemokines were measured in subjects who were screened for the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial. Urinary cytokines/chemokines were compared across low (n = 50), middle (n = 50) or high (n = 50) albumin:creatinine ratio tertile groups. Results:  At baseline, participants in the upper tertile were younger and had shorter diabetes duration compared with the other groups. Other clinical characteristics were similar. Urinary levels of interleukin 6, interleukin 8, platelet-derived growth factor-AA and RANTES differed across albumin:creatinine ratio tertiles, with higher values in patients in the middle and high tertiles compared with the lower tertile (ANCOVA P ≤ 0.01). Conclusions:  Within the normal albumin:creatinine ratio range, higher urinary albumin excretion is associated with elevated urinary levels of inflammatory markers. Ultimately, this may provide mechanistic insights into disease pathophysiology and stratify the risk of nephropathy in Type 1 diabetes. ? 2012 The Authors. Diabetic Medicine ? 2012 Diabetes UK.

Source: Diabet Med.?2012 Mar 14. doi: 10.1111/j.1464-5491.2012.03651.x. [Epub ahead of print]

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