Urinary Fetuin-A with Specific Post-Translational Modification in Type 1 Diabetes Patients with Normoalbuminuria and...

Area of Science:

• Nephrology
• Endocrinology
• Biomarker Discovery

Background:

• Post-translationally modified peptide fragments of fetuin-A (FetA) show potential as diabetic kidney disease (DKD) biomarkers.
• Previous studies linked urinary FetA-derived peptide levels (uPTM3-FetA) to DKD progression in type 2 diabetes (T2D).

Purpose of the Study:

• To investigate uPTM3-FetA excretion in type 1 diabetes (T1D) patients.
• To explore associations between uPTM3-FetA and insulin resistance, inflammation, and metabolic markers.
• To assess early renal dysfunction using estimated glomerular filtration rate (eGFR) in T1D patients.

Main Methods:

• Measured uPTM3-FetA levels in 24-hour urine samples from 169 adult T1D patients.
• Assessed renal, metabolic, inflammatory markers, adipokines, and insulin resistance (eGDR).
• Stratified patients based on median eGFR to differentiate normal and declining kidney function.

Main Results:

• No overall significant difference in uPTM3-FetA between sexes or kidney function groups.
• Male T1D patients with lower eGFR showed significantly higher uPTM3-FetA excretion than those with higher eGFR.
• Body Mass Index (BMI), hs-CRP, resistin, and HDL-cholesterol independently predicted uPTM3-FetA levels.

Conclusions:

• uPTM3-FetA may aid in detecting early renal dysfunction in male T1D patients.
• Highlights the necessity of sex-specific approaches in diabetes research and clinical practice.