Low Levels of Metrnl are Linked to the Deterioration of Diabetic Kidney Disease

Abstract

Objective

Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease. Metrnl is a secreted protein that plays an important role in kidney disease. The aim of this study was to investigate DKD-related factors and the correlation between serum Metrnl levels and the severity of DKD.

Methods

Ninety-six type 2 diabetes mellitus (T2DM) patients and 45 DKD patients were included in the study. A range of parameters were measured simultaneously, including waist-to-hip ratio (WHR), body mass index (BMI), urinary albumin/creatinine ratio (UACR), monocyte–lymphocyte ratio (MLR), albumin/globulin (A/G), liver and kidney function, blood lipid profile, islet function, and others. Subsequently, the related factors and predictive significance of DKD were identified. The correlation between the relevant factors of DKD and serum Metrnl levels with DKD was evaluated.

Results

The duration of the disease (OR: 1.12, 95% CI: 1.01–1.24, P=0.031), hypertension (OR: 4.86, 95% CI: 1.16–20.49, P=0.031), fasting blood glucose (OR: 1.23, 95% CI: 1.03–1.48, P=0.025), WHR (OR: 2.53, 95% CI: 1.03–6.22, P=0.044), and MLR (OR: 1.91, 95% CI: 1.18–3.08, P=0.008) are independent risk factors for DKD (P < 0.05). Conversely, A/G (OR: 0.13, 95% CI: 0.02–0.76, P=0.024) and Metrnl (OR: 0.99, 95% CI: 0.98–1.00, P=0.001) have been identified as protective factors against DKD. Furthermore, the level of Metrnl was negatively correlated with the severity of DKD (r_s=−0.447, P<0.001). The area under receiver operating characteristic (ROC) curves for the diagnostic accuracy of Metrnl for DKD is 0.765 (95% CI: 0.686–0.844).

Conclusion

The duration of the disease, hypertension, fasting blood glucose, WHR, and MLR are major risk factors for DKD. Metrnl and A/G are protective factors for DKD. Serum Metrnl concentrations are inversely correlated with DKD severity.

Keywords:

• diabetic kidney disease
• urinary albumin/creatinine ratio
• Metrnl
• albumin/globulin

Ethics Statement

Our study complies with all ethical regulations of the Changhai Hospital Ethics Committee and granted the ethical number: CHEC 2023-233.

Acknowledgments

The authors thank all research staff at the department of pharmacology and endocrinology and metabolism, for their participation in this study.

Disclosure

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China Major Project (82030110 and 82330117) and Youth Initiation Fund of Naval Medical University (2021QN25).