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New protein tests may allow early detection of diabetic nephropathy in children

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In children with type 1 diabetes, serum levels of two proteins may serve as markers of nephropathy before the disease can be detected by urinary albumin excretion, according to study results presented at the American Association for Clinical Chemistry Annual Scientific Meeting and Clinical Lab Expo.

Early detection is key for this complication that affects 20% to 40% of type 1 and type 2 diabetes patients, and these new biomarkers would allow for even earlier diagnosis and treatment, according to the researchers.

Ioannis Papassotiriou, PhD, director of the department of clinical biochemistry at Aghia Sophia Children’s Hospital in Athens, Greece, and colleagues measured blood levels of the two proteins — growth differentiation factor-15 (GDF-15) and chitinase-3-like-protein 1 (YKL-40) — in 56 patients with type 1 diabetes aged 9 to 15 years and 49 healthy controls aged 6 to 19 years at baseline and after 12 to 15 months. Kidney function was also evaluated through estimated glomerular filtration rate (eGFR) and measurements of neutrophil gelatinase associated lipocalin (NGAL).

At baseline, GDF-15 levels were similar in the two groups (diabetes group 289.5 pg/mL; controls 278.6 pg/mL). At follow-up, researchers reported the GDF-15 levels in patients with diabetes were significantly higher (366.7 pg/mL; P = .001) than at baseline and in controls (P < .001), and mean YKL-40 levels increased significantly in the diabetes group (from 17.4 ng/mL at baseline to 20.5 ng/mL; P < .001), but not in controls. Researchers also observed reduced kidney function in the patients with diabetes, with eGRF values declining and NGAL increasing.

“This is the first study to demonstrate a predictive role for serum GDF-15 and YKL-40 as early markers of diabetic nephropathy in children and adolescents with [type 1 diabetes] before severe overt nephropathy occurs,” Papassotiriou said in a press release. “Defining new predictors as supplementary tests to urinary albumin excretion for the early diagnosis of diabetic nephropathy could accelerate effective management and treatment approaches needed to minimize the rates of severe renal morbidity and mortality in young patients with [type 1 diabetes]. – by Cassie Homer

Reference: Papassptiriou I, et al. Abstract B-220. Presented at: American Association for Clinical Chemistry Annual Scientific Meeting and Clinical Lab Expo; July 31-August 4, 2016; Philadelphia.

Disclosure: Endocrine Today could not confirm relevant financial disclosures.