Midkine: Utility as a Predictor of Early Diabetic Nephropathy in Children with Type 1 Diabetes Mellitus

• Main Authors: Kotb Abbass Metwalley (Author), Hekma Saad Farghaly (Author), Magda Farghali Gabri (Author), Safwat Mohamed Abdel-Aziz (Author), Asmaa Mohamed Ismail (Author), Duaa Mohamed Raafat (Author), Islam Fathy Elnakeeb (Author)
• Format: Book
• Published: Galenos Yayincilik, 2021-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 1308-5727; 1308-5735; 10.4274/jcrpe.galenos.2021.2020.0303
• Keywords: midkine; type 1 diabetes mellitus; diabetic nephropathy; urinary albumin creatinine ratio; Pediatrics; RJ1-570; Diseases of the endocrine glands. Clinical endocrinology; RC648-665
• Source: JCRPE, Vol 13, Iss 3, Pp 293-299 (2021)

Objective:This study aimed to assess the role of serum midkine (MK) as a biomarker for early detection of diabetic nephropathy in children with type 1 diabetes mellitus (T1DM) before microalbuminuria emerges.Methods:A total of 120 children with T1DM, comprising 60 microalbuminuric patients (Group 1), 60 normoalbuminuric patients (Group 2), and 60 healthy participants as a control group (Group 3) were included. Detailed medical history, clinical examination, and laboratory assessment of high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c percentage (HbA1c%), lipid profile, urinary albumin to creatinine ratio (ACR), serum MK and estimated glomerular filtration rate based on serum creatinine were performed in all participants.Results:Both Group 1 and Group 2 had significantly higher serum MK compared to controls (p<0.001). Additionally, significantly higher MK concentrations were present in Group 1 compared with Group 2 (p<0.001). Receiver operating characteristic curve analysis revealed that the MK concentration cutoff value of 1512 pg/mL was able to predict microalbuminuria with a sensitivity of 96% and specificity of 92%. Stepwise regression analysis revealed that HbA1c%, hs-CRP, and ACR were independently related to MK levels (p<0.001 for each).Conclusion:The results of this study suggest that serum MK is a useful, novel, practical marker for the evaluation of renal involvement in children with T1DM, especially in normoalbuminuric children.