بررسی پروفایل اسیدهای آمینه‌ی سرم در نفروپاتی دیابتی

Background: Diabetic nephropathy is a chronic kidney disease and of more common complications of type 2 diabetes mellitus. The current diagnostic markers of diabetic nephropathy, albumin and creatinine, are only able to catch the disease in the stage of renal damage. The aim of this study is evaluation of targeted metabolomics of serum amino acids to identify the association of the changes of serum amino acid profile with diabetes and diabetic nephropathy. Methods: This cross-sectional study was conducted in 2015-2016 on thirty patients with type 2 diabetes subsequent diabetic nephropathy and thirty type 2 diabetic patients without nephropathy attending diabetes clinic of endocrinology and metabolism institute and thirty non diabetic persons. Blood hemoglobin, HbA1c and BUN and also, serum albumin, uric acid and the albumin/creatinine ratio from a random urine specimen were measured by standard methods and serum amino acids level were identified using high performance liquid chromatography (HPLC). Statistical analysis ANOVA, Kruskal-Wallis, and nominal regression were used for the comparison of the investigated groups.   Results: significant differences were seen in serum levels of 8 essential, branched-chains, aromatic and 8 non-essential amino acids alanine, aspartic acid, serine, glutamine, arginine, glycine, tyrosine and ornithine between three groups. Serum levels of arginine and isoleucine were higher in the diabetic group than non-diabetics. However, Levels of amino acids serine, glutamine, glycine, threonine, tyrosine, tryptophan, methionine, valine, ornithine, and lysine in 2 groups of diabetic nephropathy and diabetes were higher than non-diabetic patients. For every standard deviation decrease in serum levels of amino acids serine, alanine and isoleucine, in comparison to diabetic patients, the risk of diabetic nephropathy were increased 3.257 (95%CI: 0.10- 0.94, P=0.039), 2.207 (95%CI: 0.18- 0.81, P=0.039) and 2.652 (0.21- 0.96, P=0.012), respectively. Conclusion: Since this study was conducted in patients in the early stages of the disease, reduced serum levels of the amino acids serine, leucine and alanine may be associated with development and progression of diabetic nephropathy. and in the future with more studies in this field can be used in metabolic control and improvement of the prognosis of patients with diabetic nephropathy.