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Author: search.filters.author.Carolina Garfias

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    Urinary Extracellular Vesicles as a Source of NGAL for Diabetic Kidney Disease Evaluation in Children and Adolescents With Type 1 Diabetes Mellitus
    (2022)
    Francisca Ugarte
    ;
    Daniela Santapau
    ;
    Vivian Gallardo
    ;
    Carolina Garfias
    ;
    Anahí Yizmeyián
    <jats:sec><jats:title>Background</jats:title><jats:p>Tubular damage has a role in Diabetic Kidney Disease (DKD). We evaluated the early tubulointerstitial damage biomarkers in type-1 Diabetes Mellitus (T1DM) pediatric participants and studied the correlation with classical DKD parameters.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Thirty-four T1DM and fifteen healthy participants were enrolled. Clinical and biochemical parameters [Glomerular filtration Rate (GFR), microalbuminuria (MAU), albumin/creatinine ratio (ACR), and glycated hemoglobin A1c (HbA1c)] were evaluated. Neutrophil gelatinase-associated lipocalin (NGAL), Hypoxia-inducible Factor-1α (HIF-1α), and Nuclear Factor of Activated T-cells-5 (NFAT5) levels were studied in the supernatant (S) and the exosome-like extracellular vesicles (E) fraction from urine samples.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the T1DM, 12% had MAU &amp;gt;20 mg/L, 6% ACR &amp;gt;30 mg/g, and 88% had eGFR &amp;gt;140 ml/min/1.72 m<jats:sup>2</jats:sup>. NGAL in the S (NGAL-S) or E (NGAL-E) fraction was not detectable in the control. The NGAL-E was more frequent (p = 0.040) and higher (p = 0.002) than NGAL-S in T1DM. The T1DM participants with positive NGAL had higher age (p = 0.03), T1DM evolution (p = 0.03), and serum creatinine (p = 0.003) than negative NGAL. The NGAL-E correlated positively with tanner stage (p = 0.0036), the median levels of HbA1c before enrollment (p = 0.045) and was independent of ACR, MAU, and HbA1c at the enrollment. NFAT5 and HIF-1α levels were not detectable in T1DM or control.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Urinary exosome-like extracellular vesicles could be a new source of early detection of tubular injury biomarkers of DKD in T1DM patients.</jats:p></jats:sec>
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