Assessment of the Autophagy Biomarker Level In Diabetic Kidney Disease Patients

Abstract Introduction Diabetic nephropathy is the most common long-term complication of diabetes mellitus and one of its major complications is diabetic kidney disease which is a major cause of end-stage renal disease (ESRD). Recent studies suggested defective autophagy involved in the pathogenesis and progression of diabetic kidney disease. So, we aimed to assess the autophagy biomarker Beclin-1 level in diabetic kidney disease patients. Methods In a cross sectional study, we enrolled 100 patients with Diabetic Kidney Disease (DKD) referred to Ain Shams University hospital. The patients were divided into 5 groups according to the estimated glomerular filtration rate (eGFR). Each group consisted of 20 patients to Compare the level of serum Beclin-1 in different groups. Beclin 1 assay: Human Beclin 1 (BECN1) ELISA kit uses a double antibody sandwich enzyme linked immunosorbent assay (ELISA) to assay the level of Human Beclin 1 (BECN1) in samples. Results There was statistically significant difference between the studied groups (p < 0.001) regarding hemoglobin, creatinine, hemoglobin A1c, calcium, phosphate, protein creatinine ratio, eGFR, and Beclin-1 levels with highest value among group (2, 5, 4, 2, 5, 5, 5 and 5) respectively and lowest value among group (5, 1, 5, 5, 2, 1, 5 and 5) respectively. There was statistically significant inverse correlation between Beclin-1 and diabetes duration, creatinine, urea, CRP and protein creatinine ratio (r: −0.24; p = 0.026), (r: −0.44; p < 0.001), (r: −0.44; p < 0.001), (r: −0.52; p < 0.001), (r: −0.56; p < 0.001) respectively. There was statistically significant positive correlation between Beclin-1 and hemoglobin, calcium and eGFR (r: 0.242; p = 0.015), (r: 0.248; p = 0.013) and (r: 0.568; p < 0.001) respectively. At cutoff value equal to (3.3, 1.2, 1.8 and 1.1) Beclin-1 had sensitivity equal to (100%, 55%, 80% and 85%) respectively and specificity equal to (85%, 85%, 75% and 100%) respectively in prediction of CKD progression from (stage 1 to stage 2), (stage 2 to stage 3), (stage 3 to stage 4) and (stage 4 to stage 5) respectively. Conclusion In conclusion we found that eGFR was the most influential parameter affecting Beclin-1 level and by using multivariate model, linear regression analysis adjusted factors for confounders eGFR was the only factor which kept his significant correlation with Beclin-1.