Evaluating Urinary MCP-1 Levels in Patients with Diabetic Nephropathy: A Cross-Sectional Study

Abstract

Background: MCP-1 levels in urine have been shown to increase with advancing stages of diabetic nephropathy and correlate with urinary albumin excretion, a key marker of renal impairment.

Objective: To determine urinary MCP-1 levels in patients with diabetic nephropathy.

Methods: This was a hospital-based cross-sectional study conducted in the Department of Biochemistry, Vinayaka Mission's Kirupananda Variyar Medical College and Hospital, a tertiary teaching healthcare facility in Salem, Tamil Nadu, India between January 2024 and June 2024. The study included 30 healthy individuals as controls (Group A) and 90 diabetic patients diagnosed with nephropathy, up to stage 3 classification based on urinary albumin levels [Group B, patients with normoalbuminuria (UACR <30mg/g); Group C, microalbuminuria (UACR between 30 and 300mg/g); and Group D, macroalbuminuria (UACR >300mg/g)].

Results: The study analysed clinical and biochemical parameters across four groups, revealing significant differences in BMI, and alcoholism prevalence. Group D had the highest alcoholism prevalence (37.5%, p = 0.010). BMI increased progressively from Group A (23.8 ± 2.5 kg/m²) to Group D (28.4 ± 3.9 kg/m², p = 0.004). Diabetes duration was longest in Group D (10.1 ± 3.1 years, p < 0.001). No significant differences were found in smoking, blood pressure, or hypertension. Blood glucose, microalbumin, and HbA1c levels were significantly higher in diabetic groups (p < 0.001), while insulin levels showed no significant difference (p = 0.993). Other biochemical markers, including blood urea, creatinine, uric acid, and lipid profile, did not differ significantly. Urinary MCP-1 levels were elevated in diabetic groups but showed no significant intergroup differences (p = 0.209). Correlation analysis found a significant association between MCP-1 and HbA1c (r = 0.219, p = 0.001) and serum creatinine (r = 0.141, p = 0.043). ROC analysis indicated MCP-1’s predictive value for diabetes (AUC = 0.632, p = 0.041) and diabetic nephropathy with macroalbuminuria (AUC = 0.612, p = 0.086), though the latter was not statistically significant.

Conclusion: MCP-1 may be involved in the pathophysiology of diabetes and nephropathy, it is not a robust standalone biomarker for diagnosing or predicting the progression of diabetic nephropathy.