Correlation of urinary monocyte chemo-attractant protein-1 with other parameters of renal injury in type-II diabetes mellitus

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease in the western world. Increased number of interstitial macrophages has been observed in biopsies from patients with DN. Monocyte chemo-attractant protein-1 (MCP-1) is the strongest known chemo­tactic factor for monocytes and is upregulated in DN. We examined urinary levels of MCP-1 in patients with type-2 diabetes mellitus (DM) to assess its possible correlation with other para­meters of renal injury. The urinary MCP-1 level was assessed in 75 patients with type-2 DM (25 patients each with no microalbuminuria, with macroalbuminuria and, with renal impairment) and compared them with matched healthy control subjects. The HbA1c and estimated glomerular fil­tration rate (eGFR) derived from the abbreviated Modification of Diet in Renal Disease (MDRD) equation were examined in the study groups in relation to the urinary MCP-1. The urinary MCP-1 level was significantly higher in patients with micro and macroalbuminuria (167.41 ± 50.23 and 630.87 ± 318.10 ng/gm creatinine respectively) as compared with normoalbuminuric patients and healthy controls (63.85 ± 21.15 and 61.50 ± 24.81 ng/gm creatinine, p 0.001). MCP-1 correlated positively with urine albumin/creatinine ratio (ACR) (r= 0.75, p 0.001), HbA1c (r= 0.55, p 0.001) and inversely with eGFR (r=-0.60, p 0.001). Our findings suggest that hyperglycemia is associated with increased urinary levels of MCP-1 that is closely linked to renal damage as reflected by proteinuria and eGFR levels. Collectively, these findings suggest that MCP-1 is in­volved in the pathogenesis of diabetic nephropathy through its various stages.Keywords: Monocyte chemo-attractant protein, Diabetes, Renal injury