Clinical significance and different levels of urinary monocyte chemoattractant protein-1 in Type 2 diabetes mellitus

Objective: Monocyte chemoattractant protein-1(MCP-1) is a cytokine that exhibits most potent chemotactic activity toward monocytes. It is suggested to be implicated in the development and progression of diabetic nephropathy by playing a role in infiltration of monocyte/macrophage. Recent studies have demonstrated that urinary monocyte chemoattractant protein-1 (uMCP-1) is different at different stages of diabetic nephropathy. Based on these findings, the aim of this study is to examine the level of uMCP-1 and its clinical significance at different stages of diabetic nephropathy and at the same time to describe the relationship between uMCP-1 and the various parameters. Methods: Fifty-nine cases with type 2 diabetes mellitus (T2DM) were divided into three groups according to urine albumin excretion (UAE): normal albuminuria group, microalbuminuria group and macroalbuminuria group. The levels of uMCP-1, protein excretion, blood urea nitrogen (BUN), serum creatinine (s-Cr), glycohemoglobin A1c (HbA1c), blood pressure and blood fat were measured in 59 patients with T2DM and 27 healthy adults as controls. Results Compared with normal control, levels of uMCP-1 in T2DM were significantly high, which were already elevated in normal albuminuria group. Compared with normal albuminuria group, levels of uMCP-1 in microalbuminuria group and macroalbuminuria group were significantly high. Levels of uMCP-1 in macroalbuminuria group were higher than those in microalbuminuria group. The level of uMCP-1 was positively correlated with UAE, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) in T2DM patients, while it had no significant correlation with HbA1c, triglyceride (TG) and high density lipoprotein cholesterol (HDL-C). Conclusions: MCP-1 is suggested to be implicated in the development and progression of diabetic nephropathy. it is very important to measure the level of uMCP-1 in the diagnosis and intervention of early diabetic nephropathy. (C) 2008 Elsevier Ireland Ltd. All rights reserved.