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 (DKD) is a microvascular complication of diabetes with complex pathogenesis. Wingless signaling-mediated renal fibrosis is associated with DKD. Dickkopf-1, a negative regulator of Wingless, has been proven to be participating in renal fibrosis, glucose metabolism, and inflammation. However, whether serum Dickkopf-1 levels are associated with diabetic kidney disease remains unclear.
Are there any correlations between serum Dickkopf-1 levels and glucose levels or albuminuria in type 2 diabetic individuals? Answering this question will provide significant insight into understanding the roles of Dickkopf-1 in DKD.
In this study, we assessed the relationship between serum Dickkopf-1 levels and albuminuria in individuals with type 2 diabetes. This will be helpful for the exploration of the mechanism of Dickkopf-1 in DKD.
Seventy-three type 2 diabetes 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 (UACR). 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, and those in the macroalbuminuria group were the lowest. Bivariate analysis revealed that serum Dickkopf-1 levels were positively correlated with hemoglobin A1c levels and estimated glomerular filtration rate, but negatively correlated with diabetes duration, systolic blood pressure, serum creatinine level, and UACR. Multiple and logistic regression showed that serum Dickkopf-1 levels were independently associated with UACR.
We have identified that serum Dickkopf-1 levels are negatively associated with UACR. Lower serum Dickkopf-1 levels could be a critical risk factor for albuminuria in diabetes.
Dickkopf-1, as an endogenous inhibitor of the Wnt pathway, mediates various effects on the microvascular complications of diabetes, including DKD. The value of the study allows scientists to better understand the mechanisms of DKD for treatment in the future.