LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2 (Lp‐PLA2) AS A PREDICTOR OF END-STAGE RENAL DISEASE IN PATIENTS WITH DIABETIC NEPHROPATHY

Authors

  • Irena Kostovska Institute of Medical and Experimental Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Svetlana Cekovska Institute of Medical and Experimental Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Katerina Tosheska Trajkovska Institute of Medical and Experimental Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Danica Labudovic Institute of Medical and Experimental Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Julijana Brezovska Kavrakova Institute of Medical and Experimental Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Sonja Topuzovska Institute of Medical and Experimental Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Melda Emin Institute of Medical and Experimental Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Hristina Ampova Institute of Medical and Experimental Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Elena Stanojevska Institute of Medical and Experimental Biochemistry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Natasa Nedeska Minova City General Hospital 8th September, Department of Endocrinology, Diabetes and Metabolic Diseases, Skopje, Republic of North Macedonia

Keywords:

Lipoprotein-associated phospholipase A2, Diabetic nephropathy, Chronic kidney disease

Abstract

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a specific biomarker for vascular inflammation. It is associated with microvascular complications such as diabetic nephropathy (DN) in patients with type 2 diabetes mellitus. To determine the predictive value of Lp-PLA2 concentration/activity for end-stage renal disease (ESRD) in patients with DN.

A total of 94 patients included in this cross-sectional study with DN were divided into four stages of chronic kidney disease (CKD) according to CKD-EPI: Stage II (n=20), Stage IIIa (n=29), Stage IIIb (n=38), and Stage IV (n=7). Forty-four healthy subjects were used as a control group. In addition to anamnestic data (age, gender, body weight, height, glycemic control), we measured the concentration of glucose, total cholesterol, triacylglycerols, blood urea, and creatinine in the blood serum using standard photometric methods. Lp-PLA2 concentration/activity was measured by chemiluminescence immunoassay-CLIA. Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) serum creatinine was used to determine the GFR and CKD stages.

We found significant differences among subgroups of patients with DN divided according to CKD stage and healthy subjects regarding age, body mass index, duration of disease, blood glucose, glycated hemoglobin, total cholesterol, triacylglycerols, blood urea, serum creatinine, GFR, and Lp-PLA2. A significant negative correlation was found between Lp‐PLA2 and GFR. ROC analysis showed that Lp-PLA2 had a positive predictive value of 98.3% in patients with DN. Lp-PLA2 gradually increased in stages of DN.

Lp-PLA2 could be considered as a potential predictive biomarker for the progression of DN  to ESRD.

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Published

2024-12-11

Issue

Vol. 4 No. 3 (2024): Acad Med J

Section

Original Articles