P-331: Role of urinary osteopontin in early prediction of diabetic nephropathy in adolescents with type 1 diabetes mellitus
H Atwa, B Mosbah, H Osman, E ElnagarAbstract
Introduction
Osteopontin is one of the cytokine systems that is selectively up regulated in the serum of Type 1 Diabetes patients, in their vascular walls, and in their kidneys.
Objectives
To measure the level of urinary osteopontin and to evaluate its role in early prediction of diabetic nephropathy in adolescents with type 1 diabetes.
Methods
cross-sectional study included 120 adolescents. They were categorized into three groups, Group 1 Type 1 Diabetes Mellitus with ACR <30 mg/g (normoalbuminuric). Group 2: Type 1 Diabetes Mellitus with ACR is 30-300 mg/g (micro albuminuric). Group 3: Controls with ACR <30 mg/g (normo albuminuric). Data collection sheet including demographic data, diabetes duration, Clinical examination and laboratory data as serum creatinine, Urinary albumin creatinine ratio. Fasting lipid profile including; cholesterol, TG, HDL and LDL, Mean of HbA1C levels, Urinary OPN, were measured.
Results
Urinary OPN was significantly higher among diabetic with microalbuminuria. At cut off >65 was assessed, it had a significant role in prediction of microalbuminuria from normoalbuminuria among diabetic adolescent with a sensitivity of 90%, specificity of 70%, PPV of 75%, NPV of 87.5% and area under curve was 92%. There was a high moderate positive correlation between OPN and ACR among diabetic patients (r =0.65). Also, HbA1c was moderately correlated with OPN (r =0.66) in diabetic groups. Similarly, there was a moderate positive correlation between diastolic blood pressure and OPN in diabetics. Furthermore, a weak positive correlation was revealed for both duration of diabetes and LDL with OPN. But, there is no significant relation between Osteopontin and gender.
Conclusions
Urinary OPN may be used as a screening test for diabetic nephropathy in type 1 diabetes with high sensitivity and moderate specificity. This study found that poor glycemic control had a role in progression of diabetic nephropathy.