Pyroptosis-mediator Gasdermin D in serum: a potential biomarker in diabetic kidney disease

To evaluate whether serum Gasdermin D (GSDMD) levels are associated with diabetic kidney disease (DKD) and renal function impairment, and to assess its potential diagnostic value.

This cross-sectional observational study included 111 patients with DKD, 100 patients with non-diabetic kidney diseases, and 135 healthy controls. Serum GSDMD levels were measured using a chemiluminescence assay. Associations between GSDMD and clinical parameters were analyzed using Spearman correlation and binary logistic regression. Receiver operating characteristic (ROC) curves were constructed to evaluate diagnostic performance.

Serum GSDMD levels were significantly higher in patients with DKD than in healthy controls (P < 0.05). GSDMD levels were positively correlated with glucose (GLU), creatinine (CREA), blood urea nitrogen (BUN), and urinary albumin-to-creatinine ratio (UACR), and negatively correlated with estimated glomerular filtration rate (eGFR) (all P < 0.01). Multivariate logistic regression identified GSDMD as an independent factor associated with DKD. The area under the ROC curve (AUC) for GSDMD in identifying DKD was 0.847 (95% CI: 0.808-0.886), which increased to 0.933 (95% CI: 0.904-0.962) when combined with conventional indicators.

Serum GSDMD levels are significantly associated with diabetic kidney disease and renal dysfunction. These findings suggest that GSDMD may serve as a complementary biomarker for DKD assessment; however, longitudinal and multicenter studies are required to confirm its prognostic value and clinical applicability.