title: Higher urine heat shock protein 70/creatinine ratio in type 1 diabetes mellitus.
abstract: Insidious progressive renal damage caused by type 1 diabetes mellitus (T1DM) begins in childhood before it becomes manifest in adult ages. Heat shock proteins (HSPs) regulate the cell response to any hazardous factors to prevent cell structure. The aim of the study is to determine whether urine levels of HSPs increase in diabetic children with time and indicate a progressive renal injury in T1DM. Thirty-three patients with T1DM and 24 healthy children were enrolled in the study. Renal function was normal in all patients. Urine levels of HSP27, HSP40, HSP60, HSP70, and HSP90 were measured by enzyme-linked immunosorbent assay at two consecutive years (2012 and 2013). The results were evaluated as urine HSP/creatinine ratios (uHSP/Cr). Mean urine HSP27/Cr, HSP40/Cr, HSP60/Cr, HSP70/Cr, HSP90/Cr in patient group were significantly higher than in controls in 2012 (uHSP27/Cr 460.12 ± 217.64 versus 270.02 ± 136.83 pg/mgCr; uHSP40/Cr 180.89 ± 118.59 versus 99.44 ± 62.49 pg/mgCr; uHSP60/Cr 114.40 ± 64.91 versus 70.50 ± 43.70 pg/mgCr; uHSP70/Cr 41.17 ± 28.42 versus 16.47 ± 7.32 pg/mgCr; uHSP90/Cr 175.64 ± 102.22 versus 107.61 ± 75.85 pg/mgCr) (p < 0.05). In 2013, uHSP70/Cr level increased significantly (51.08 ± 27.72 pg/mgCr; p = 0.001), whereas uHSP60/Cr level decreased and uHSP27/Cr, uHSP40/Cr, uHSP90/Cr levels remained stable (p > 0.05). Area under the curve (AUC) for uHSP70/Cr (0.957) was significantly higher than the others. Using a cutoff 22.59 pg/mgCr for uHSP70/Cr to predict of diabetic damage, sensitivity and specificity were 85% and 96%, respectively. Our results suggest that uHSP70/Cr increases over time and may indicate early phases of progressive kidney damage in diabetic children.
authors.affiliation: a Pediatric Nephrology Department, Istanbul Medical Faculty , Istanbul University , Istanbul , Turkey ;
authors.forename: Alev
authors.initials: A
authors.lastname: Yilmaz
authors.affiliation: b Biochemistry Department , Bakirkoy Dr. Sadi Konuk Training and Research Hospital , Istanbul , Turkey ;
authors.forename: Asuman
authors.initials: A
authors.lastname: Gedikbasi
authors.affiliation: a Pediatric Nephrology Department, Istanbul Medical Faculty , Istanbul University , Istanbul , Turkey ;
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Yuruk Yildirim
authors.affiliation: a Pediatric Nephrology Department, Istanbul Medical Faculty , Istanbul University , Istanbul , Turkey ;
authors.forename: Cemile
authors.initials: C
authors.lastname: Pehlivanoglu
authors.affiliation: c Pediatrics Department, Istanbul Medical Faculty , Istanbul University , Istanbul , Turkey ;
authors.forename: Basak
authors.initials: B
authors.lastname: Seker
authors.affiliation: a Pediatric Nephrology Department, Istanbul Medical Faculty , Istanbul University , Istanbul , Turkey ;
authors.forename: Aysegul
authors.initials: A
authors.lastname: Sucu
authors.affiliation: d Pediatric Endocrinology Department, Istanbul Medical Faculty , Istanbul University , Istanbul , Turkey.
authors.forename: Ruveyde
authors.initials: R
authors.lastname: Bundak
authors.affiliation: a Pediatric Nephrology Department, Istanbul Medical Faculty , Istanbul University , Istanbul , Turkey ;
authors.forename: Sevinc
authors.initials: S
authors.lastname: Emre
mesh_terms: D000293:Adolescent; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine*; D003922:Diabetes Mellitus, Type 1 / Q000652:urine*; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D018840:HSP70 Heat-Shock Proteins / Q000652:urine*; D006801:Humans; D007677:Kidney Function Tests; D008297:Male
chemical_list: D015415:Biomarkers; D018840:HSP70 Heat-Shock Proteins; D003404:Creatinine
keywords: Children; diabetes; diabetic nephropathy; heat shock protein; nephropathy