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J Nephrol. 2016 Feb;29(1):37-44. doi: 10.1007/s40620-015-0199-8. Epub 2015 Apr 24.

Urinary podocalyxin, the novel biomarker for detecting early renal change in obesity.

Author information

1
Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand. jjiabjiab@hotmail.com.
2
Pasteur Institute du Laos, Samsenthai Road, Ban Kao-Gnot, Sisattanak district, P.O Box 3560, Vientiane, Lao PDR. thip_mt@hotmail.com.
3
Department of Internal Medicine, University of Hawaii, 1356 Lusitana Street, Honolulu, HI, 96813, USA. veeravich_j@hotmail.com.
4
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. doctorkrit@gmail.com.
5
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. doctorkrit@gmail.com.
6
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. awannarat@yahoo.com.
7
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. a_leelahavanit@yahoo.com.
8
Immunology Unit, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. a_leelahavanit@yahoo.com.
9
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. golfnephro@hotmail.com.
10
Kidney and Metabolic Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. golfnephro@hotmail.com.

Abstract

BACKGROUND:

The prevalence of obesity is increasing during the past decade along with obesity-related glomerulopathy (ORG), glomeruli injury due to the obesity. The major pathogenesis of ORG is the shedding of podocytes from the glomerular cell barrier into urine. Podocalyxin (PCX), a main surface antigen of podocyte, correlates well with glomerulosclerosis progression and glomerular injury severity, and might be a potential biomarker for early renal alteration in obesity. In addition, vascular endothelial growth factor (VEGF) and alpha-smooth muscle actin (α-SMA) also play a role in promoting glomerulosclerosis. The aim of this study was to explore whether obese subjects without other diseases excrete more PCX-positive (PCX+) cells than non-obese individuals, in comparison with urine protein-creatinine ratio (UPCR) and glomerular filtration rate (GFR) as traditional renal markers. Moreover, the effect of body mass index (BMI) on urinary VEGF, PCX or α-SMA positive cells was also investigated.

METHODS:

Forty-eight obese and 13 non-obese adults were included. Exfoliated cells from fresh first void morning urine were harvested, stained with PCX, VEGF, and α-SMA antibody, and quantified by flow cytometry. Correlation between interested urinary biomarkers (cells positive for PCX, VEGF plus PCX and α-SMA), UPCR and GFR with BMI and metabolic risk factors were analyzed.

RESULTS:

Obese patients had significantly higher PCX+ cells than non-obese [0.62 (0.00-13.13) vs. 0.15 (0.00-0.72) cells/ml × mg cr, p < 0.05]. There was no significant difference in GFR and UPCR between the groups. Of interest, BMI demonstrated a correlation with PCX+ cells (r = 0.343, p = 0.008) and cells positive for PCX plus VEGF (r = 0.374, p = 0.004).

CONCLUSION:

Obese subjects without other diseases and with normal UPCR and GFR showed evidence of renal alteration through the detection of a higher number of PCX+ cells. Increasing BMI also resulted in higher number of PCX+ cells.

KEYWORDS:

Metabolic syndrome; Obesity; Podocalyxin; Podocyte; Proteinuria

PMID:
25905599
DOI:
10.1007/s40620-015-0199-8
[Indexed for MEDLINE]

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