Undiagnosed Kidney Injury in Uninsured and Underinsured Diabetic African American Men and Putative Role of Meprin Metalloproteases in Diabetic Nephropathy.
Undiagnosed Kidney Injury in Uninsured and Underinsured Diabetic African American Men and Putative Role of Meprin Metalloproteases in Diabetic Nephropathy.
复制标题
未保险和保险不足的非洲裔美国糖尿病男性中未确诊的肾损伤以及 Meprin 金属蛋白酶在糖尿病肾病中的假定作用。
DOI：
10.1155/2018/6753489
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发表时间：
2018
影响因子：
2.1
通讯作者：
Ongeri,ElimeldaMoige
中科院分区：
文献类型：
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作者：
Cao,Lei;Sedighi,Rashin;Boston,Ava;Premadasa,Lakmini;Pinder,Jamilla;Crawford,GeorgeE;Jegede,OlugbemigaE;Harrison,ScottH;Newman,RobertH;Ongeri,ElimeldaMoige
糖尿病是慢性肾脏病的主要原因。非裔美国人承受着不成比例的糖尿病肾病 (DKD) 和终末期肾病 (ESRD) 的负担。 DKD 的差异具有遗传和社会经济因素，但其在非裔美国人中的患病率尚未得到充分研究。目前的研究使用多种 DKD 生物标志物来评估北卡罗来纳州格林斯伯勒市未投保和投保不足的非裔美国男性中未确诊的 DKD。参与者分为三组：非糖尿病对照组、无已知肾脏疾病的糖尿病患者和诊断为 DKD 的糖尿病患者。我们的数据显示，根据肾损伤的血浆和尿液生物标志物水平，即尿白蛋白与肌酐比、肾损伤分子-1、胱抑素 C 和中性粒细胞明胶酶相关脂质运载蛋白的水平，很大一部分糖尿病患者存在未确诊的肾损伤。我们还发现，meprin A、meprin B 和两个肾脏 meprin 靶标（nidogen-1 和单核细胞趋化蛋白-1）的尿液水平随着肾损伤的严重程度而增加，这表明 meprin 金属蛋白酶在该亚群 DKD 的病理生理学中具有潜在作用。该研究还表明，需要进行更积极的测试来评估未投保的糖尿病患者的肾损伤，以促进早期诊断和有针对性的干预措施，从而减缓 ESRD 的进展。
Diabetes is the leading cause of chronic kidney disease. African Americans are disproportionately burdened by diabetic kidney disease (DKD) and end stage renal disease (ESRD). Disparities in DKD have genetic and socioeconomic components, yet its prevalence in African Americans is not adequately studied. The current study used multiple biomarkers of DKD to evaluate undiagnosed DKD in uninsured and underinsured African American men in Greensboro, North Carolina. Participants consisted of three groups: nondiabetic controls, diabetic patients without known kidney disease, and diabetic patients with diagnosed DKD. Our data reveal undiagnosed kidney injury in a significant proportion of the diabetic patients, based on levels of both plasma and urinary biomarkers of kidney injury, namely, urinary albumin to creatinine ratio, kidney injury molecule‐1, cystatin C, and neutrophil gelatinase‐associated lipocalin. We also found that the urinary levels of meprin A, meprin B, and two kidney meprin targets (nidogen‐1 and monocytes chemoattractant protein‐1) increased with severity of kidney injury, suggesting a potential role for meprin metalloproteases in the pathophysiology of DKD in this subpopulation. The study also demonstrates a need for more aggressive tests to assess kidney injury in uninsured diabetic patients to facilitate early diagnosis and targeted interventions that could slow progression to ESRD.