Potential Relationship Between Macrophage Inflammatory Protein-1β and Diabetic Kidney Disease: A Multi-Model Study

Inflammatory chemokines may participate in the progression of diabetic kidney disease (DKD). However, the clinical value of macrophage inflammatory protein-1β (MIP-1β) for identifying macroalbuminuria in DKD remains insufficiently defined. This study aims to construct a nomogram-based prediction model to evaluate MIP-1β level in predicting DKD progression.

In this prospective, single-center observational study, 198 DKD patients and 198 type 2 diabetes mellitus patients without DKD were consecutively recruited from July 2021 to July 2023. DKD patients were stratified into microalbuminuria (A2, n=146) and macroalbuminuria (A3, n=52) groups. Multivariate logistic regression identified risk factors for macroalbuminuria. A nomogram incorporating significant variables was constructed and internally validated using bootstrap method. Model performance was evaluated via receiver operating characteristic (ROC) analysis and decision curve analysis.

MIP-1β levels were significantly higher in the DKD group than non-DKD group (78.88±21.18 vs 67.75±16.25 pg/mL, P<0.001). For predicting DKD, MIP-1β had an area under the ROC curve of 0.711 (95% CI: 0.661-0.762), with 62.6% sensitivity and 74.2% specificity. Independent risk factors for macroalbuminuria included MIP-1β (adjusted odds ratio=1.089, 95% CI: 1.052-1.127), urea nitrogen (1.694, 95% CI: 1.142-2.513), and cystatin C (7.728, 95% CI: 1.843-32.400). The nomogram incorporating these predictors achieved 88.5% sensitivity and 91.1% specificity, with C-index of 0.852 and good calibration.

MIP-1β level is independently associated with macroalbuminuria in DKD patients. The nomogram model demonstrates high predictive value for macroalbuminuria and may assist risk stratification in DKD patients; however, external validation is required.