title: Association of peripheral nesfatin-1 with early stage diabetic nephropathy.
abstract: BACKGROUND
  Nesfatin-1 is a newly found anorectic neuropeptide with potent metabolic regulatory effects that its circulating levels are shown to be elevated in diabetes. We compared serum nesfatin-1 in patients with type 2 diabetes and microalbuminuria (30mg/day≤urinary albumin excretion (UAE) <300mg/day) with their control patients with type 2 diabetes and normoalbuminuria (UAE <30mg/day).
  
  
  METHODS
  In a cross sectional setting, 44 adult patients with type 2 diabetes and microalbuminuria and 44 control patients with type 2 diabetes and normoalbuminuria were evaluated. Serum levels of nesfatin-1 along with demographic, clinical and biochemical factors associated with diabetes was measured.
  
  
  RESULTS
  Mean peripheral concentrations of nesfatin-1 were significantly higher in patients with diabetes who had microalbuminuria compared to normoalbuminuric control patients (175.27±25.96pg/ml vs. 134.66±23.18pg/ml, respectively; p value<0.001). Significant positive correlations were found between circulating nesfatin-1 levels and the following case-mix variables: duration of diabetes, glycated hemoglobin, plasma creatinine, UAE and serum uric acid. In the multivariate logistic regression and after adjustment for a constellation of potentially confounding variables associated with diabetic kidney disease (DKD), circulating nesfatin-1 was the only variable significantly associated with microalbuminuria (odds ratio [95% confidence interval]=1.224 [1.007-1.487], p value=0.042).
  
  
  CONCLUSIONS
  In patients with type 2 diabetes, circulating nesfatin-1 appears to be associated with microalbuminuria independent of other established risk factors of DKD. The underlying pathophysiological mechanisms and the prognostic significance of this association remain to be elucidated.
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: amin.irannejad@yahoo.com.
authors.forename: Amin
authors.initials: A
authors.lastname: Irannejad
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: ghajar.ar@gmail.com.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ghajar
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: mhafarideh@gmail.com.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Afarideh
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: elyas.khajeh@gmail.com.
authors.forename: Elias
authors.initials: E
authors.lastname: Khajeh
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: sina.noshad@gmail.com.
authors.forename: Sina
authors.initials: S
authors.lastname: Noshad
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: sadaf217@gmail.com.
authors.forename: Sadaf
authors.initials: S
authors.lastname: Esteghamati
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: khashayarafshari@gmail.com.
authors.forename: Khashayar
authors.initials: K
authors.lastname: Afshari
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: farima.kahe@yahoo.com.
authors.forename: Farima
authors.initials: F
authors.lastname: Kahe
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: morsaleh.ganji@yahoo.com.
authors.forename: Morsaleh
authors.initials: M
authors.lastname: Ganji
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: saadatagah.m@gmail.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Saadat
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: nakhjavanim@tums.ac.ir.
authors.forename: Manouchehr
authors.initials: M
authors.lastname: Nakhjavani
authors.affiliation: Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: esteghamati@tums.ac.ir.
authors.forename: Alireza
authors.initials: A
authors.lastname: Esteghamati
keywords: Diabetic kidney disease; Diabetic nephropathy; Microalbuminuria; Nesfatin-1