Kidney Week

Abstract: TH-PO409

Association Between Urinary A Megalin and Metabolic Syndrome in Japanese Adults

Session Information

• CKD: Risk Scores and Translational Epidemiology
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Kabasawa, Keiko, Niigata University, Niigata, Japan

Keiko Kabasawa,

• Hosojima, Michihiro, Niigata University, Niigata, Japan

Michihiro Hosojima,

• Ito, Yumi, Niigata University, Niigata, Japan

Yumi Ito,

• Kurosawa, Hiroyuki, Denka Seiken Co., Ltd, Gosen, Japan

Hiroyuki Kurosawa,

• Kabasawa, Hideyuki, Niigata University, Niigata, Japan

Hideyuki Kabasawa,

• Hirayama, Yoshiaki, Denka Seiken Co., Ltd, Gosen, Japan

Yoshiaki Hirayama,

• Nakamura, Kazutoshi, Niigata University, Niigata, Japan

Kazutoshi Nakamura,

• Saito, Akihiko, Niigata University, Niigata, Japan

Akihiko Saito,

• Matsushima, Kazuo, Yukiguni Yamato Hospital, Minamiuonuma, Japan

Kazuo Matsushima,

• Tanaka, Junta, Niigata University, Niigata, Japan

Junta Tanaka,

• Narita, Ichiei, Niigata University, Niigata, Japan

Ichiei Narita,

Background

Metabolic syndrome (MetS) is a risk factor for chronic kidney disease (CKD). Megalin is an endocytic receptor in proximal tubule epithelial cells that mediates the endocytosis of glomerular-filtered toxic substances and is recognized as a potential therapeutic target for MetS-related CKD. Although microalbuminuria is a well-known marker of MetS-related CKD, markers for its early detection remain unestablished. Thus, in this study, we assessed the association of urinary biomarkers including ectodomain (A-megalin) and full-length (C-megalin) forms of megalin with MetS in Japanese adults.

Methods

Among 348 subjects (184 men; average age 61.3 years old) with urine albumin-to-creatinine ratio (ACR) < 300 mg/g on health check examination, urine biomarkers including A-megalin, C-megalin, ACR, α₁-microglobulin (a1M), β₂-microglobulin, N-acetyl-β-D-glucosaminidase, and podocalyxin were assessed cross-sectionally. MetS scores were adopted from National Cholesterol Education Program (third revision) of the Adult Treatment Panel criteria modified for Asians; subjects with ≥3 components were diagnosed as having MetS.

Results

Subjects included 97 patients with MetS, 20 with diabetes, and 134 with hypertension; median body mass index, estimated glomerular filtration rate (eGFR) and ACR were 22.6 kg/m², 74.4 mL/min/1.73 m², and 7.5 mg/g, respectively. MetS scores were positively correlated with urinary A-megalin, ACR, and a1M in Spearman’s partial correlation analysis, adjusted for sex and age (r = 0.12, 0.25, and 0.13, respectively). In multivariable logistic regression analysis, higher urinary A-megalin was positively associated with MetS even after adjustment for age, sex, diabetes, hypertension, ACR and eGFR (adjusted odds ratio of MetS for elevated quartile of A-megalin: 1.37, 95% CI: 1.06-1.77, P = 0.01).

Conclusion

Urinary A-megalin was independently associated with MetS in a Japanese adult population. Further longitudinal studies are needed to confirm the association of urinary A-megalin with the development and progression of MetS-related CKD.

Funding

• Commercial Support – Denka Seiken Co., Ltd.