Document Detail

Urinary monocyte chemoattractant protein-1 (MCP-1) and connective tissue growth factor (CCN2) as prognostic markers for progression of diabetic nephropathy.
MedLine Citation:
PMID:  19409809     Owner:  NLM     Status:  MEDLINE    
Profibrotic growth factors and inflammatory chemokines have been implicated in the pathogenesis of diabetic nephropathy (DN). However, measurement of urinary monocyte chemoattractant protein-1 (MCP-1) and connective tissue growth factor (CCN2) as prognostic markers has not previously been reported, and neither have two such molecules in urine been examined in a single study of DN. In this prospective observational study, 43 adult diabetic patients were studied, 40 were followed up for 6years. Urinary MCP-1/creatinine ratios were found to be significantly higher in patients with macroalbuminuria (3.3- and 2.1-fold higher (p<0.01) than normoalbuminuric and microalbuminuric patients, respectively). CCN2 exhibited a pattern different from that of urinary MCP-1. Urinary CCN2/creatinine ratios were greatly elevated in both microalbuminuric and macroalbuminuric patients (125- and 74-fold higher than normoalbuminuric patients, respectively, p<0.01 and p<0.05, respectively). Further, urinary CCN2, but not MCP-1, correlated with progression of microalbuminuria (R=0.49, p<0.05). In contrast, MCP-1, but not CCN2, correlated with the rate of eGFR decline for all patients (R=0.61, p<0.0001), reflective of its predictive value in patients with macroalbuminuria, but not for patients with microalbuminuria or normoalbuminuria. In conclusion, increased urinary CCN2 is associated with the early progression of DN, whereas MCP-1 is associated with later stage disease.
Frederick W K Tam; Bruce L Riser; Karim Meeran; JoAnn Rambow; Charles D Pusey; Andrew H Frankel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-05
Journal Detail:
Title:  Cytokine     Volume:  47     ISSN:  1096-0023     ISO Abbreviation:  Cytokine     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-26     Completed Date:  2009-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9005353     Medline TA:  Cytokine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  37-42     Citation Subset:  IM    
Imperial College Kidney and Transplant Institute, Renal Section, Division of Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
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MeSH Terms
Albuminuria / urine
Biological Markers / urine
Blood Pressure / physiology
Chemokine CCL2 / urine*
Connective Tissue Growth Factor / urine*
Creatinine / urine
Diabetes Mellitus, Type 1 / complications,  urine
Diabetes Mellitus, Type 2 / complications,  urine
Diabetic Nephropathies / diagnosis*,  physiopathology,  urine*
Diabetic Retinopathy / urine
Glomerular Filtration Rate / physiology
Hemoglobin A, Glycosylated / metabolism
Middle Aged
Young Adult
Reg. No./Substance:
0/Biological Markers; 0/CCL2 protein, human; 0/CTGF protein, human; 0/Chemokine CCL2; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human; 139568-91-5/Connective Tissue Growth Factor; 60-27-5/Creatinine

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