RELATIONSHIP BETWEEN GLYCOCALYX COMPONENTS AND MICROALBUMINURIA IN PATIENTS WITH DIABETES MELLITUS

Main Article Content

Shanza Rafi
Kamran Shauket
Shazia Naz
Zunairah Hamayun
Nasir Islam
Tayyaba Yasin
Hafsa Yasin
Filza Karim
Rizwana Dilshad

Keywords

Diabetes; Microalbuminuria; Glycocalyx metabolites.

Abstract

Diabetes mellitus is a disease of deregulated blood glucose homeostasis. Microalbuminuria has been
described as an early sign of kidney damage. The aim of the study was to determine the association
of glycocalyx metabolites with microalbuminuria in type 1 diabetic patients. To determine the
association of glycocalyx metabolites with microalbuminuria in diabetic patients. This cross-sectional
study was recruited from the 90 patient’s department of Children's Hospital on the recommendation
of a consultant endocrinologist. Patients were designated as having microalbuminuria if they had a
24-h urine measurement >30 mg or an albumin-to-creatinine ratio >30 mg/g albumin-to-creatinine.
Total cholesterol, HDL cholesterol, and triglycerides were measured by standard enzymatic methods.
Blood and urine samples were obtained from diabetic patients. A probability value of P<0.05 was
determined to be statistically significant. The analysis of patient ages indicated a mean age of
12.62±1.73 years. Out of the total of 90 patients, 55 (61.11%) were identified as male, while 35
(38.89%) were identified as female. The Mean albumin to creatinine ration in patients was
356.17±139.24 respectively. The Mean cholesterol level in patients was 182.43±50.89. The meantriglyceride level in patients was 154.17±118.49. Mean HbA1c level in patients was 11.52±1.36.
Mean hyaluronic acid level in patients was 283.83±29.51. Hyaluronic acid displayed weak positive
correlations with creatinine (r=0.348) and HbA1c levels (r=0.209), and a moderate correlation with
the albumin-to-creatinine ratio (r=0.424). A positive significant correlation was observed between
hyaluronic acid and ACR. This study suggests that there is a correlation between hyaluronan and ACR
in children with T1DM, indicating the importance of monitoring these measures in the management
of T1DM.

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References

1. Ahn, M. B., Cho, K. S., Kim, S. K., Kim, S. H., Cho, W. K., Jung, M. H., Suh, J.-S., and Suh, B.-
K. (2021). Poor Glycemic Control Can Increase the Plasma Kidney Injury Molecule-1
Concentration in Normoalbuminuric Children and Adolescents with Diabetes Mellitus. Children,
8(5), 417.
2. Aldecoa, C., Llau, J. V., Nuvials, X., and Artigas, A. (2020). Role of albumin in the preservation
of endothelial glycocalyx integrity and the microcirculation: a review. Annals of intensive care,
10, 1-12.
3. Alphonsus, C., and Rodseth, R. (2014). The endothelial glycocalyx: a review of the vascular
barrier. Anaesthesia, 69(7), 777-784.
4. Balbotkina, E., and Kutina, A. (2023). Structure and Properties of the Glomerular Filtration
Barrier in Vertebrates: Role of a Charge in Protein Filtration. Journal of Evolutionary
Biochemistry and Physiology, 59(6), 1891-1910.
5. Butler, M. (2018). Aldosterone-induced Endothelial Glycocalyx Dysfunction, a Potential
Therapeutic Target in Proteinuria? University of Bristol].
6. Cortinovis, M., Perico, N., Ruggenenti, P., Remuzzi, A., and Remuzzi, G. (2022). Glomerular
hyperfiltration. Nature reviews nephrology, 18(7), 435-451.
7. Dogné, S., and Flamion, B. (2020). Endothelial glycocalyx impairment in disease: focus on
hyaluronan shedding. The American journal of pathology, 190(4), 768-780.
8. Dong, Q., Huang, J., Liu, S., Yang, L., Li, J., Li, B., Zhao, X., Li, Z., and Wu, L. (2019). A survey
on glycemic control rate of type 2 diabetes mellitus with different therapies and patients’
satisfaction in China. Patient preference and adherence, 1303-1310.
9. Fayfman, M., and Haw, S. (2017). Diabetes in racial and ethnic minorities in the United States:
Individualizing approaches to diagnosis and management. Current Diabetes Reviews, 13(3), 239-
250.
10. Franceković, P., and Gliemann, L. (2023). Endothelial Glycocalyx Preservation—Impact of
Nutrition and Lifestyle. Nutrients, 15(11), 2573.
11. Herman, W. H., Schillinger, D., Bolen, S., Boltri, J. M., Bullock, A., Chong, W., Conlin, P. R.,
Cook IV, J. W., Dokun, A., and Fukagawa, N. (2023). The National Clinical Care Commission
report to Congress: recommendations to better leverage federal policies and programs to prevent
and control diabetes. Diabetes care, 46(2), 255-261.
12. Hu, Z., Cano, I., and D’Amore, P. A. (2021). Update on the role of the endothelial glycocalyx in
angiogenesis and vascular inflammation. Frontiers in Cell and Developmental Biology, 9,
734276.
13. Hull, R. L., Bogdani, M., Nagy, N., Johnson, P. Y., and Wight, T. N. (2015). Hyaluronan: a
mediator of islet dysfunction and destruction in diabetes? Journal of Histochemistry and
Cytochemistry, 63(8), 592-603.
14. Kazemzadeh, K., Bayani, M., Khademi, R., Sadat-Madani, S.-F., Habibzadeh, A., Shirani, M.,
Ghadri, H., Abbasalizadeh, M., Izadi, E., and Rezaee, M. (2024). Association of serum omentin
levels with microvascular complications of type 2 diabetes mellitus: a systematic review and
meta-analysis. Journal of Diabetes and Metabolic Disorders, 23(1), 239-249.
15. Korakas, E., Ikonomidis, I., Markakis, K., Raptis, A., Dimitriadis, G., and Lambadiari, V. (2020).
The endothelial glycocalyx as a key mediator of albumin handling and the development of
diabetic nephropathy. Current Vascular Pharmacology, 18(6), 619-631.
16. Ledeganck, K. J., den Brinker, M., Peeters, E., Verschueren, A., De Winter, B. Y., France, A.,
Dotremont, H., and Trouet, D. (2021). The next generation: Urinary epidermal growth factor is
associated with an early decline in kidney function in children and adolescents with type 1
diabetes mellitus. diabetes research and clinical practice, 178, 108945.
17. Marcovecchio, M. L., Colombo, M., Dalton, R. N., McKeigue, P. M., Benitez‐Aguirre, P.,
Cameron, F. J., Chiesa, S. T., Couper, J. J., Craig, M. E., and Daneman, D. (2020). Biomarkers
associated with early stages of kidney disease in adolescents with type 1 diabetes. Pediatric
diabetes, 21(7), 1322-1332.
18. Masola, V., Zaza, G., Arduini, A., Onisto, M., and Gambaro, G. (2021). Endothelial glycocalyx
as a regulator of fibrotic processes. International journal of molecular sciences, 22(6), 2996.
19. Nadhiya, J., Vijayalakshmi, M., and Showbharnikhaa, S. (2024). A Brief Review on Diabetes
Mellitus. Journal of Pharma Insights and Research, 2(1), 117-121.
20. Nasri, H., and Rafieian-Kopaei, M. (2015). Diabetes mellitus and renal failure: Prevention and
management. Journal of research in medical sciences, 20(11), 1112-1120.
21. Popoviciu, M. S., Paduraru, L., Nutas, R. M., Ujoc, A. M., Yahya, G., Metwally, K., and Cavalu,
S. (2023). Diabetes mellitus secondary to endocrine diseases: an update of diagnostic and
treatment particularities. International journal of molecular sciences, 24(16), 12676.
22. Poredos, P., Poredos, A. V., and Gregoric, I. (2021). Endothelial dysfunction and its clinical
implications. Angiology, 72(7), 604-615.
23. Premaratne, E., Verma, S., Ekinci, E. I., Theverkalam, G., Jerums, G., and MacIsaac, R. J. (2015).
The impact of hyperfiltration on the diabetic kidney. Diabetes and metabolism, 41(1), 5-17.
24. Qi, B., Lou, Y., Zhu, Y., Chen, Y., Yang, S., Meng, F., Pan, Z., Liu, S., Yan, G., and Lu, X.
(2024). Elevated RHAMM as a biomarker for predicting diabetic kidney disease in patients with
type 2 diabetes. Clinical Kidney Journal, 17(7).
25. Rabelink, T. J., and De Zeeuw, D. (2015). The glycocalyx—linking albuminuria with renal and
cardiovascular disease. Nature reviews nephrology, 11(11), 667-676.
26. Rathsman, B., Haas, J., Persson, M., Ludvigsson, J., Svensson, A. M., Lind, M., Andersson
Franko, M., and Nyström, T. (2021). LDL cholesterol level as a risk factor for retinopathy and
nephropathy in children and adults with type 1 diabetes mellitus: a nationwide cohort study.
Journal of internal medicine, 289(6), 873-886.
27. Salmon, A. H., and Satchell, S. C. (2012). Endothelial glycocalyx dysfunction in disease:
albuminuria and increased microvascular permeability. The Journal of pathology, 226(4), 562-
574.
28. Sana, M. A., Chaudhry, M., Malik, A., Iqbal, N., Zakiuddin, A., and Abdullah, M. (2020).
Prevalence of microalbuminuria in type 2 diabetes mellitus. Cureus, 12(12).
29. Scilletta, S., Di Marco, M., Miano, N., Filippello, A., Di Mauro, S., Scamporrino, A., Musmeci,
M., Coppolino, G., Di Giacomo Barbagallo, F., and Bosco, G. (2023). Update on diabetic kidney
disease (DKD): focus on non-albuminuric DKD and cardiovascular risk. Biomolecules, 13(5),
752.
30. Selby, N. M., and Taal, M. W. (2020). An updated overview of diabetic nephropathy: Diagnosis,
prognosis, treatment goals and latest guidelines. Diabetes, Obesity and Metabolism, 22, 3-15.
31. Sharma, M., Singh, V., Sharma, R., Koul, A., McCarthy, E. T., Savin, V. J., Joshi, T., and
Srivastava, T. (2022). Glomerular biomechanical stress and lipid mediators during cellular
changes leading to chronic kidney disease. Biomedicines, 10(2), 407.
32. Wu, G., Liu, S., Hagenstein, J., Alawi, M., Hengel, F. E., Schaper, M., Akyüz, N., Liao, Z.,
Wanner, N., and Tomas, N. M. (2024). Adeno-associated virus–based gene therapy treats
inflammatory kidney disease in mice. The Journal of Clinical Investigation, 134(17).
33. Yu, H., Song, Y.-Y., and Li, X.-H. (2023). Early diabetic kidney disease: focus on the glycocalyx.
World journal of diabetes, 14(5), 460.