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Abstract: FR-PO439

Urine Synaptopodin Predicts Progression of Diabetic Nephropathy in Patients with Type 2 Diabetes

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Cho, Nam-Jun, Soonchunhyang University Cheonan Hospital, Cheonan, Korea (the Republic of)
  • Lee, Eun-Young, Soonchunhyang University Cheonan Hospital, Cheonan, Korea (the Republic of)
  • Chung, Choon Hee, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
  • Kang, Minhwan, Soonchunhyang University Cheonan Hospital, Cheonan, Korea (the Republic of)
Background

Synaptopodin, a protein that plays an important role in the maintenance of the structure of podocyte, is known as a marker that reflects the damage of glomerulus. Although some studies reported that urine synaptopodin was elevated in diverse kidney diseases, the clinical role of urine synaptopodin in the diabetic patients remains unclear. We hypothesized that urine levels of synaptopodin would be associated with severity and prognosis of diabetic nephropathy.

Methods

A total of 145 patients with type 2 diabetes and 25 healthy control subjects were enrolled. They were followed up with estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR) and urine protein-to-creatinine ratio. The participants with baseline eGFR less than 60 mL/min/1.73 m2 were excluded. Urine levels of synaptopodin were assessed by enzyme-linked immunosorbent assays.

Results

The mean age of the study participants was 56.2 ± 10.5 years and their median follow-up was 36 (24–40) months. Urine synaptopodin levels, presented as urine synaptopodin-to-creatinine ratio, were significantly higher in patients with diabetes (256.0 [142.0–481.7] pg/mg) than healthy control (129.2 [96.5–289.1] pg/mg). Among diabetic patients, urine synaptopodin levels were increased according to albuminuria stages (normoalbuminuria, 234.3 [140.1–470.7] pg/mg; microalbuminuria, 258.3 [143.8–424.6] pg/mg; and macroalbuminuria, 341.8 [178.7–570.6] pg/mg).
Urine synaptopodin in diabetic patients was not significantly correlated with baseline eGFR. However, urine synaptopodin was negatively correlated with changes of eGFR (R = 0.209, p = 0.023). Moreover, in the normoalbuminuric subgroup of diabetic patients, urine synaptopodin was significantly associated with changes of UACR (R = 0.272, p = 0.045). This finding was also valid after adjusting for age, sex, body mass index, glycated hemoglobin level, eGFR, and follow-up duration.

Conclusion

Our study presented that urine synaptopodin in patients with type 2 diabetes reflected the severity of diabetic nephropathy and predicted progression of the disease. These results suggest that urine synaptopodin would be a useful early biomarker for diabetic nephropathy.