ISSN: 1308-5727 | E-ISSN: 1308-5735
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Turkish Society for Pediatric Endocrinology and Diabetes
Urine Levels of Matrix Metalloproteinases and Tissue Inhibitor of Metalloproteinases in Children with Type 1 Diabetes Mellitus [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2019; 11(2): 157-163 | DOI: 10.4274/jcrpe.galenos.2018.2018.0221

Urine Levels of Matrix Metalloproteinases and Tissue Inhibitor of Metalloproteinases in Children with Type 1 Diabetes Mellitus

Zeynep Yürük Yıldırım1, Alev Yılmaz1, Cemile Pehlivanoğlu1, Asuman Gedikbaşı2, Mehmet Yıldız3, Ahmet Dirican4, Rüveyde Bundak5, Feyza Darendeliler5, Sevinç Emre1, Ahmet Nayır1
1İstanbul University İstanbul Faculty of Medicine, Department of Pediatric Nephrology, İstanbul, Turkey
2Bakırköy Dr. Sadi Konuk Training and Research Hospital, Clinic of Biochemistry, İstanbul, Turkey
3İstanbul University İstanbul Faculty of Medicine, Department of Pediatrics, İstanbul, Turkey
4İstanbul University İstanbul Faculty of Medicine, Department of Biostatistics, İstanbul, Turkey
5İstanbul University Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey

Objective: Histopathological changes in the kidney in type 1 diabetes mellitus (T1DM) begin before detection of microalbuminuria. Therefore, there is interest in finding a better biomarker for the early detection of diabetic kidney injury. The aim of this present study was to determine whether urinary indicators of fibrosis are detectable early in the development of T1DM in children and if they may predict progressive renal injury.
Methods: Urinary matrix metalloproteinase 2 and 9 (MMP2 and MMP9), tissue inhibitor of metalloproteinase 1 and 2 (TIMP1 and TIMP2) and transforming growth factor-ß1 (TGF-ß1) were assessed in 33 patients with T1DM with normal renal functions and in 24 healthy controls. Microalbuminuria was not present in the patient group with the exception of three patients. The results were adjusted to urine creatinine (Cr) and the differences between patients and controls were evaluated. These measurements were repeated after one year and the results were compared with the first year results.
Results: Urine MMP2/Cr, MMP9/Cr, TIMP1/Cr, TIMP2/Cr, TGF-ß1/Cr were not different between the patient and control groups (p>0.05). There were also no significant differences between the first and second year results for these biomarkers (p>0.05). None of these parameters were correlated with hemoglobin A1c, body mass index and duration of T1DM. Interestingly, all parameters were negatively correlated to age of onset of T1DM (p<0.05).
Conclusion: Our findings suggest that urinary biomarkers of fibrosis do not show an increase in diabetic children without microalbuminuria. The results also indicate that the risk of early fibrosis may increase as age of onset of T1DM decreases.

Keywords: Type 1 diabetes mellitus, diabetic nephropathy, children, biomarker, MMP, TIMP

Zeynep Yürük Yıldırım, Alev Yılmaz, Cemile Pehlivanoğlu, Asuman Gedikbaşı, Mehmet Yıldız, Ahmet Dirican, Rüveyde Bundak, Feyza Darendeliler, Sevinç Emre, Ahmet Nayır. Urine Levels of Matrix Metalloproteinases and Tissue Inhibitor of Metalloproteinases in Children with Type 1 Diabetes Mellitus. J Clin Res Pediatr Endocrinol. 2019; 11(2): 157-163
Manuscript Language: English
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