ROLE OF URINARY OSTEOPONTIN IN EARLY PREDICTION OF DIABETIC NEPHROPATHY IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS
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Keywords
Osteopontin, DM, nephropathy, adolescent
Abstract
Background: Type 1 diabetes is one of the most common endocrine diseases in pediatrics. One of the most serious micro-vascular complications is diabetic nephropathy. Osteopontin is one of the cytokine systems that is selectively regulated in the serum of Type 1 Diabetes patients, in their vascular walls, and in their kidneys.
Aim and Objectives: This study aimed to improve the quality of life of adolescents with type 1 diabetes by the main objective to measure the level of urinary osteopontin and to evaluate its role in early prediction of diabetic nephropathy in adolescents with type 1 diabetes.
Methods: This cross-sectional study included 120 adolescents. They were categorized into three groups, Group 1 Type 1 Diabetes Mellitus with ACR <30 mg/g (normo albuminuric). Group 2: Type 1 Diabetes Mellitus with ACR is 30-300 mg/g (micro albuminuric). Group 3: Controls with ACR <30 mg/g (normo albuminuric). Data collection sheet including demographic data, diabetes duration, Clinical examination and laboratory data as serum creatinine, Urinary albumin creatinine ratio. Fasting lipid profile including cholesterol, TG, HDL and LDL, Mean of HbA1C levels, Urinary OPN, were measured.
Results: The three groups studied were age and gender matched. Urinary OPN was significantly higher among diabetics with microalbuminuria. At cut off >65 was assessed, it had a significant role in prediction of microalbuminuria from normoalbuminuria among diabetic adolescents with a sensitivity of 90%, specificity of 70%, PPV of 75%, NPV of 87.5% and area under curve was 92%.
There was a high moderate positive correlation between OPN and ACR among diabetic patients (r =0.65). Also, HbA1c was moderately correlated with OPN (r =0.66) in diabetic groups. Similarly, there was a moderate positive correlation between diastolic blood pressure and OPN in diabetics. Furthermore, a weak positive correlation was revealed for both duration of diabetes and LDL with OPN. But there is no significant relation between Osteopontin and gender.
Conclusion: Urinary OPN may be used as a screening test for diabetic nephropathy in type 1 diabetes with high sensitivity and moderate specificity. This study found that poor glycemic control had a role in progression of diabetic nephropathy.
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Heba Mohamed El Sayed Osman
M.B. B.Ch. (2013), M.SC. (2019), Assistant lecturer of Pediatrics and Neonatology, Faculty of Medicine Suez Canal University (FOMSCU).
Hoda Ahmed Atwa
Professor of Pediatrics, Suez Canal University.
Badr Eldin Mohammed Mosbah
Professor of Pediatrics, Suez Canal University.
Enas Fathy Elngar
Assistant Professor of Pediatrics, Suez Canal University.