Urinary SIRT2 Reflects Kidney Injury in Type 2 Diabetes.

IF 2.3 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Kidney & blood pressure research Pub Date : 2024-01-01 Epub Date: 2024-06-20 DOI:10.1159/000539886
Yali Dai, Dan Li, Juan Peng, Yanfang Luo, Lianlian Xiong, Su Wu, Xiangyu Liao, Bin Yi
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Abstract

Introduction: The early diagnosis of kidney injury in type 2 diabetes (T2DM) is important to prevent the long-term damaging effects of kidney loss and is decisive for patient outcomes. While SIRT2 is implicated in diabetes pathogenesis, its correlation with diabetic nephropathy remains unexplored. This study was designed to evaluate the association of urine SIRT2 levels with diabetic kidney injury, as well as potential underlying mechanisms.

Methods: In T2DM patients, db/db mice, and high glucose plus palmitic acid treated HK2 cell models, ELISA, Immunoturbidimetry, Immunohistochemistry, Western blot, and Quantitative real-time polymerase chain reaction were used to detect SIRT2 levels and kidney damage. According to urinary albumin/creatinine ratio (UACR), 163 T2DM patients were divided into three groups. Spearman correlation analysis was used to investigate the relationship between urinary sirtuin2/creatinine ratio (USCR) and biomarkers of kidney injury. The influencing factors of albuminuria in T2DM patients were analyzed by logistic regression model.

Results: In our findings, the Macro group exhibited the highest USCR levels as UACR increased. There was a positive association between USCR and UACR, α1-microglobulin/creatinine ratio (UαCR), β2-microglobulin/creatinine ratio (UβCR), and retinol-binding protein/creatinine ratio (URCR), with a negative correlation observed with eGFR. Logistic ordered multiclassification regression analysis, adjusting for confounding variables, confirmed that USCR remained a significant risk factor for the severity of albuminuria in T2DM patients. In the db/db mice kidney SIRT2 protein level increased significantly. Increased SIRT2 protein levels were also observed in renal tubular epithelial cells treated with high glucose plus palmitic acid. Moreover, SIRT2 promotes the expression of proinflammatory factors TNF-α and IL-6 by modulating the phosphorylation of p38 MAPK and p-JNK in renal tubular cells induced by high glucose and palmitic acid.

Conclusion: Urinary SIRT2 is closely related to eGFR, renal tubule injury, and urinary albumin excretion in T2DM patients, which is expected to be an important indicator to comprehensively reflect renal injury.

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尿液 SIRT2 反映 2 型糖尿病患者的肾损伤情况
导言:2 型糖尿病(T2DM)肾损伤的早期诊断对于防止肾功能丧失的长期破坏性影响非常重要,并且对患者的预后起着决定性作用。虽然 SIRT2 与糖尿病发病机制有关,但其与糖尿病肾病的相关性仍未得到探讨。本研究旨在评估循环和尿液中 SIRT2 水平与糖尿病肾损伤的关系以及潜在的内在机制:方法:在T2DM患者、db/db小鼠和高糖加棕榈酸处理的HK-2细胞模型中,采用ELISA、免疫比浊法、免疫组织化学、Western blot和RT-qPCR等方法检测SIRT2水平和肾脏损伤。根据尿白蛋白/肌酐比值(UACR),将 163 名 T2DM 患者分为三组。采用斯皮尔曼相关分析研究了尿 SIRT2/肌酐比值(USCR)与肾损伤生物标志物之间的关系。通过逻辑回归模型分析了T2DM患者蛋白尿的影响因素:我们的研究结果表明,随着 UACR 的增加,宏观组的 USCR 水平最高。USCR与UACR、α1-微球蛋白/肌酐比值(UαCR)、β2-微球蛋白/肌酐比值(UβCR)和视黄醇结合蛋白/肌酐比值(URCR)呈正相关,与eGFR呈负相关。在对混杂变量进行调整后,逻辑有序多分类回归分析证实 USCR 仍是 T2DM 患者蛋白尿严重程度的重要风险因素。在 db/db 小鼠的肾组织中,KIM-1 水平的升高与 SIRT2 水平的升高有关。在用高葡萄糖加棕榈酸处理的肾小管上皮细胞中也观察到了 SIRT2 蛋白水平的升高。此外,SIRT2 通过调节高糖和棕榈酸诱导的肾小管细胞中 p38 MAPK 和 pJNK 的磷酸化,促进促炎因子 TNF-α 和 IL-6 的表达:尿SIRT2与T2DM患者的eGFR、肾小管损伤和尿白蛋白排泄密切相关,有望成为全面反映肾损伤的重要指标。
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来源期刊
Kidney & blood pressure research
Kidney & blood pressure research 医学-泌尿学与肾脏学
CiteScore
4.80
自引率
3.60%
发文量
61
审稿时长
6-12 weeks
期刊介绍: This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.
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