الفهرس 
Diagnostic implication of urinary 8-hydroxy-2-eoxyguanosine (8-OHdG) as a novel biomarker for early prediction of diabetic kidney disease in adolescents with type 1 diabetes mellitus
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Abstract
Introduction: Diabetic microvascular complications (DMCs) involve nephropathy, retinopathy, and neuropathy. Diabetic kidney disease (DKD) is the most frequent and serious complication. It is the main cause of chronic kidney disease, which begins with normoalbuminuria and progresses to microalbuminuria, macroalbuminuria, and finally end stage kidney disease.The severity of DKD is assessed by the amount of albuminuria present, but it lacks the sensitivity and specificity needed to detect an early stage of DKD, so other biomarkers are needed. One of these biomarkers is urinary 8-Hydroxy-2-Deoxyguanosine (8-OHdG). Objectives:The aim of this study is to assess the sensitivity and specificity of urinary 8-OHdG as a novel biomarker for early detection of DKD in adolescents with type 1 diabetes mellitus (T1DM). Methods:The study included 91 participants; 64 adolescents with T1DM following at the DEMPU at Children’s Hospital of Cairo University, and 27 healthy adolescents who were recruited as a control group from subjects accompanying their parents visiting sick siblings and relatives in Children’s Hospital of Cairo University.T1DM patients were classified according to their urinary albumin/creatinine ratio (UACR) resultsinto 3 groups: group A (normoalbuminuria), group B (persistent microalbuminuria), and group C (recurrent microalbuminuria). A questionnaire was taken from T1DM patients; including: chronological age, gender, age at onset of T1DM, insulin dose, types, and regimen, use of angiotensin converting enzyme inhibitors (ACEIs), history suggestive of other diabetic complications, and history of other diseases (such as cardiovascular, renal, and urinary tract, hepatic, respiratory, neurodegenerative, and psychiatric diseases). Blood pressure and anthropometric measurements were performed for every participant. Laboratory tests were requested within 3 months of T1DM patient recruitment and included: glycosylated haemoglobin (HbA1c),full lipid profile (serum total cholesterol, serum triglycerides, serum low density lipoprotein-cholesterol, and serum high density lipoprotein-cholesterol), kidney function tests (serum creatinine and urea), and UACR. The estimated glomerular filtration rate (eGFR) was calculated using the Schwartz formula. Urine samples were collected from all study participants at the time of their recruitment and tested for urinary 8-OHdG using ELISA kits. Results: Mean HbA1c in the last 5 years was above the target level ({u2265}7%) in 96.9% of the group of T1DM patients. There was a highly statistically significant difference between T1DM patients and the control group, and between the 3 groups of T1DM regarding urinary 8-OHdG