Published online Jan 15, 2021. doi: 10.4239/wjd.v12.i1.47
Peer-review started: July 16, 2020
First decision: September 17, 2020
Revised: September 28, 2020
Accepted: November 10, 2020
Article in press: November 10, 2020
Published online: January 15, 2021
Diabetic kidney disease is a microvascular complication of diabetes with complex pathogenesis. Wingless signaling-mediated renal fibrosis is associated with diabetic kidney disease. Dickkopf-1, a negative regulator of Wingless, has been proven to participate in renal fibrosis, glucose metabolism, and inflammation. However, whether serum Dickkopf-1 levels are associated with diabetic kidney disease remains unclear.
To assess the relationship between serum Dickkopf-1 levels and albuminuria in individuals with type 2 diabetes.
Seventy-three type 2 diabetes patients and 24 healthy individuals were enrolled in this case-control study. Diabetic individuals were separated into normal albuminuria, microalbuminuria, and macroalbuminuria groups based on their urinary albumin/creatinine ratios (UACRs). Clinical characteristics and metabolic indices were recorded. Serum Dickkopf-1 levels were determined by enzyme-linked immunosorbent assay.
No significant difference in serum Dickkopf-1 levels was found between healthy individuals and the normal albuminuria group. However, the levels in the microalbuminuria group were significantly lower than those in the normal albuminuria group (P = 0.017), and those in the macroalbuminuria group were the lowest. Bivariate analysis revealed that serum Dickkopf-1 levels were positively correlated with hemoglobin A1c level (r = 0.368, P < 0.01) and estimated glomerular filtration rate (r = 0.339, P < 0.01), but negatively correlated with diabetes duration (r = -0.231, P = 0.050), systolic blood pressure (r = -0.369, P = 0.001), serum creatinine level (r = -0.325, P < 0.01), and UACR (r = -0.459, P < 0.01). Multiple and logistic regression showed that serum Dickkopf-1 levels were independently associated with UACR (odds ratio = 0.627, P = 0.021).
Serum Dickkopf-1 levels are negatively associated with UACR. Lower serum Dickkopf-1 levels could be a critical risk factor for albuminuria in diabetes.
Core Tip: This study explored the relationship between circulating Dickkopf-1 levels and albuminuria in type 2 diabetic individuals. Multiple characteristics and metabolic indices were collected, and analyses were performed using various statistical methods. The main finding was that circulating Dickkopf-1 levels were negatively correlated with albuminuria and lower Dickkopf-1 could be a risk factor for albuminuria in diabetes.