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Intensive insulin therapy decreases urinary MCP-1 and ICAM-1 excretions in incipient diabetic nephropathy

S D Ye1, M Zheng, L L Zhao

  • 1Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, China. ysd6464@yahoo.com.cn

European Journal of Clinical Investigation
|August 12, 2009
PubMed
Abstract

Insights

Intensive insulin therapy for type 2 diabetes with microalbuminuria significantly reduces inflammatory markers monocyte chemoattractant protein-1 (MCP-1) and intercellular adhesion molecule-1 (ICAM-1), potentially protecting against diabetic nephropathy.

Area of Science:

  • Endocrinology and Metabolism
  • Nephrology
  • Inflammation Research

Background:

  • Type 2 diabetes (T2D) management often involves intensive insulin treatment to control blood glucose and reduce chronic complications.
  • Inflammation plays a critical role in T2D and its complications, including diabetic nephropathy (DN).
  • Monocyte chemoattractant protein-1 (MCP-1) and intercellular adhesion molecule-1 (ICAM-1) are key inflammatory chemokines implicated in T2D pathogenesis.

Purpose of the Study:

  • To investigate the association between type 2 diabetes with microalbuminuria and elevated urinary MCP-1 and ICAM-1 levels.
  • To evaluate the effect of intensive insulin therapy on urinary MCP-1, ICAM-1, and albumin (Alb) in T2D patients with microalbuminuria.
  • To determine if intensive insulin therapy reduces inflammation and improves renal markers in early DN.

Main Methods:

  • Recruitment of 30 type 2 diabetics with microalbuminuria for a 2-week intensive insulin therapy regimen.
  • Collection of serial spot urine samples for measurement of urinary MCP-1, ICAM-1, and Albumin (Alb) levels, corrected for creatinine (Cr).
  • Comparison of pre- and post-treatment urinary marker levels to assess therapeutic impact.

Main Results:

  • Urinary MCP-1/Cr and ICAM-1/Cr ratios were significantly elevated in type 2 diabetic patients with microalbuminuria compared to controls.
  • Intensive insulin treatment led to a significant reduction in urinary MCP-1/Cr, ICAM-1/Cr, and Alb/Cr ratios.
  • These findings suggest a decrease in inflammatory markers and albuminuria following intensive insulin therapy.

Conclusions:

  • Intensive insulin treatment demonstrates potential in mitigating renal injury in early diabetic nephropathy.
  • The renoprotective effect may be attributed to the reduction in urinary MCP-1 and ICAM-1 excretions.
  • This highlights the importance of managing inflammation in T2D patients with early signs of kidney disease.

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