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Increased plasma fibronectin concentration in diabetic patients with microalbuminuria
L A De Giorgio1, G Bartolomei, A Gironi
1Outpatient Clinic for Diabetes, Pistoia, Italy.
Abstract:
Raised levels of plasma fibronectin (PF), an alpha 2-glycoprotein produced by vascular endothelia, have been previously described in diabetic patients with retinopathy and overt nephropathy. The aim of this study was to investigate whether the presence of microalbuminuria is associated with increased PF concentrations. Twenty Albustix-negative diabetic outpatients with microalbuminuria [median albumin excretion rate (AER): 30.2 micrograms/min; range 12.1-194 micrograms/min] were compared with 58 sex- and age-matched patients without microalbuminuria (median AER 3.1 micrograms/min; range 0.8-12 micrograms/min) and 34 control subjects (median AER 2.8 micrograms/min; range 0.8-12.1 micrograms/min). Mean PF was significantly higher in the group with microalbuminuria (406.7 +/- 85.5 micrograms/ml) than in the group without it (325.3 +/- 76.5 micrograms/ml or in control subjects (334.5 +/- 76 micrograms/ml; P less than .05). PF increase associated with microalbuminuria was independent of the presence of retinopathy. Furthermore, in the whole group of diabetic patients, PF was significantly correlated with AER (r = .33; P = .003). Such correlation also remained significant (P = .0002) after covariance analysis by a stepwise discriminant procedure taking into account age, duration of disease, sex, blood pressure, body weight, therapy, and HbA1. In conclusion, PF increase is associated with microalbuminuria independent of the other considered variables; its role as a possible marker for early diabetic nephropathy remains to be fully clarified.
Insights
Increased plasma fibronectin (PF) levels are linked to microalbuminuria in diabetes. This finding suggests PF may serve as an early marker for diabetic nephropathy, independent of other factors.
Area of Science:
- Endocrinology and Metabolism
- Nephrology
- Vascular Biology
Background:
- Plasma fibronectin (PF) elevations are noted in diabetic patients with retinopathy and overt nephropathy.
- Microalbuminuria signifies early kidney damage in diabetes.
Purpose of the Study:
- To determine if microalbuminuria correlates with increased plasma fibronectin concentrations in diabetic patients.
- To investigate PF as a potential early indicator of diabetic nephropathy.
Main Methods:
- Compared PF levels in diabetic patients with and without microalbuminuria against control subjects.
- Analyzed PF correlation with albumin excretion rate (AER) and other clinical variables.
- Utilized covariance analysis to assess independence from age, duration, sex, blood pressure, and glycemic control (HbA1).
Main Results:
- Mean PF was significantly higher in diabetic patients with microalbuminuria compared to those without and controls (P < .05).
- PF elevation associated with microalbuminuria was independent of retinopathy.
- A significant positive correlation was found between PF and AER (r = .33, P = .003), persisting after adjusting for covariates.
Conclusions:
- Increased plasma fibronectin is associated with microalbuminuria in diabetes, independent of other clinical factors.
- PF may represent a valuable biomarker for detecting early-stage diabetic nephropathy.
- Further research is needed to fully elucidate the role of PF in diabetic kidney disease progression.