Organic pollutants increase nephropathy risk in diabetes
By Sally Robertson, medwireNews Reporter
29 April 2013
J Diabetes Investig 2013; Advance online publication

medwireNews: Individuals with diabetes may reduce their risk for developing nephropathy if they minimize their exposure to persistent organic pollutants (POPs), suggest researchers.

In a study of 104 participants with diabetes, POP levels measured by the Chemically Activated LUciferase gene eXpression (CALUX) assay, were elevated in those with versus without nephropathy, report Hong Kyu Lee (Eulji University, Seoul, South Korea) and colleagues.

The team also found that diabetic nephropathy was an independent risk factor for higher serum POP levels.

The researchers used the CALUX assay to screen the patients' serum for ligands that bind to and activate the aryl hydrocarbon receptor (AhR). The POPs dioxin and dioxin-like compounds are well recognized ligands that bind to AhR and subsequent AhR transactivating (AHRT) activity reflects levels of these POPS.

"To our knowledge, this is the first study to show the association between serum AHRT activity and diabetic nephropathy," say Lee and team.

Among the patients, who were aged a mean of 60.5 years, 36 had normoalbuminuria with a urinary albumin-creatinine ratio (UACR) of less than 30 mg/g creatinine, 29 had microalbuminuria (UACR 30-99 mg/g creatinine), eight had macroalbuminuria (UACR ≥300 mg/g), and 31 had end-stage renal disease (ESRD) and were receiving dialysis for renal replacement.

As reported in the Journal of Diabetes Investigation, the mean serum AHRT level was significantly higher in the microalbuminuria, macroalbuminuria, and ESRD groups than in the normoalbuminuria group, at 40.1 pmol/L, 37.4 pmol/L, and 59.1 pmol/L versus 12.7 pmol/L, respectively.

Serum AHRT activity was correlated with estimated glomerular filtration rate and serum creatinine level, as well as known risk factors for the progression of nephropathy systolic blood pressure, glycated hemoglobin, and duration of diabetes.

Furthermore, multivariate analysis showed that diabetic nephropathy was a significant predictor for AHRT activity, after adjustment for confounders.

"The study findings suggest that finding ways to prevent exposure to POPs or to attenuate their actions at molecular levels might play a role in preventing diabetic microvascular complications," suggest Lee et al.

They also note: "POPs are accumulated in animal fats, so minimizing consumption of animal fats might reduce the risk."

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

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