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Open AccessArticle

Urinary Proteomics for the Early Diagnosis of Diabetic Nephropathy in Taiwanese Patients

1
Graduate Institute of Integrated Medicine, China Medical University, Taichung 404, Taiwan
2
Center for Personalized Medicine, China Medical University Hospital, Taichung 404, Taiwan
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Division of Nephrology and Kidney Institute, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan
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Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung 404, Taiwan
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Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 404, Taiwan
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School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
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Department of Medical Research, Taichung Veterans General Hospital, Taichung 404 Taiwan
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Department of Social Work, Tunghai University, Taichung 404, Taiwan
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Proteomics Core Laboratory, Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan
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Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
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Department of Health and Nutrition Biotechnology, Asia University, Taichung 404, Taiwan
*
Authors to whom correspondence should be addressed.
Fuu-Jen Tsai and Chao-Jung Chen contributed equally to this work.
J. Clin. Med. 2018, 7(12), 483; https://doi.org/10.3390/jcm7120483
Received: 11 October 2018 / Revised: 16 November 2018 / Accepted: 22 November 2018 / Published: 26 November 2018
(This article belongs to the Section Nephrology & Urology)
Diabetic nephropathy (DN) is a major complication in diabetic patients. Microalbuminuria testing is used to identify renal disease; however, its predictive value is questionable. We aimed to identify urinary biomarkers to early diagnosis nephropathy before identifiable alternations in kidney function or urine albumin excretion occurs. Proteomic approaches were used to identify potential urinary biomarkers and enzyme-linked immunosorbent assay was performed to verify the results. The data identified haptoglobin (HPT) and α-1-microglobulin/bikunin precursor (AMBP) as two biomarkers with the highest ability to distinguish between healthy individuals and patients with nephropathy, and between diabetic patients with and without DN. Further, the HPT-to-creatinine ratio (HCR) was evaluated as an independent predictor of early renal functional decline (ERFD) in a cohort with an average follow-up of 4.2 years. The area under the curve (AUC) value for ERFD prediction was significantly improved when the HCR biomarker was included in the model with albumin to creatinine ratio (ACR) and baseline characteristics (AUC values were 0.803 and 0.759 for HCR and ACR, respectively; p value was 0.0423 for difference between models). In conclusion, our results suggest that HCR represents an early indicator of nephropathy, and a marker related to ERFD among diabetic patients in Taiwan. View Full-Text
Keywords: proteomics; early prediction; nephropathy proteomics; early prediction; nephropathy
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MDPI and ACS Style

Liao, W.-L.; Chang, C.-T.; Chen, C.-C.; Lee, W.-J.; Lin, S.-Y.; Liao, H.-Y.; Wu, C.-M.; Chang, Y.-W.; Chen, C.-J.; Tsai, F.-J. Urinary Proteomics for the Early Diagnosis of Diabetic Nephropathy in Taiwanese Patients. J. Clin. Med. 2018, 7, 483.

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