Urinary podocyte-derived microparticles in youth with type 1 and type 2 diabetes
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SHORT COMMUNICATION
Urinary podocyte-derived microparticles in youth with type 1 and type 2 diabetes Katie M. Sullivan 1,2 & James Scholey 3,4 & Rahim Moineddin 5 & Etienne Sochett 2 & Brandy Wicklow 6,7 & Yesmino Elia 2 & Feng Xiao 8 & Thalia Mederios 8 & Pusha Sadi 6,7 & Dylan Burger 8 & Farid H. Mahmud 2 & Alison B. Dart 6,7 Received: 22 June 2020 / Accepted: 18 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Aims/hypothesis The release of podocyte-derived microparticles into the urine may reflect early kidney injury in diabetes. We measured the urinary excretion of podocyte-derived microparticles in youth with type 1 and type 2 diabetes, and related the values to blood pressure, renal function and blood glucose levels. Methods Cross-sectional, exploratory analysis of urine samples and clinical data from youth with type 1 (n = 53) and type 2 (n = 50) diabetes was carried out. Urinary podocyte-derived microparticle numbers, measured by flow cytometry, were assessed in relation to measures of blood glucose levels and renal function. Results Podocyte-derived microparticle excretion (MPE) normalised to urinary creatinine (MP/UCr) was higher in type 1 vs type 2 diabetes (median [IQR] MP/UCr: 7.88 [8.97] vs 1.84 [8.62]; p < 0.0001), despite the type 2 diabetes group having higher blood pressure (systolic blood pressure, median [range]: 124 [110–154] vs 114 [94–143] mmHg) and higher proportions of microalbuminuria (44.0% vs 13.2%), but shorter time since diabetes diagnosis (median [range]: 1.2 [0.0–7.0] vs 6.4 [2.0– 13.9] years), than the type 1 diabetes cohort. MPE in youth with type 1 diabetes was associated with blood glucose (p = 0.01) and eGFR (p = 0.03) but not HbA1c, systolic or diastolic blood pressure or urine albumin/creatinine ratio. After adjustment for age at baseline, duration of diabetes, sex and BMI, the association with eGFR remained significant (p = 0.04). No associations were found between MPE and these clinical variables in youth with type 2 diabetes. Conclusions/interpretation Significant associations between podocyte MPE, blood glucose levels and eGFR were observed in youth with type 1 diabetes but not in those with type 2 diabetes, notwithstanding increased renal pathology in the type 2 diabetes cohort. These findings suggest that podocyte injury differs in the two diabetes cohorts.
Dylan Burger, Farid H. Mahmud and Alison B. Dart contributed equally to this study. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00125-020-05297-z) contains peer-reviewed but unedited supplementary material, which is available to authorised users. * Katie M. Sullivan [email protected] 1
Renal Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
2
Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
3
Department of Medicine, University of Toronto, Toronto, ON, Canada
4
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