Fractalkine in type 2 Egyptian diabetics with and without nephropathy

Background Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetic nephropathy is the major microvascular complication of diabetes mellitus; one of the earliest clinical signs of diabetic nephropathy is an elevated urinary albumin excretion (UAE), referred to as microalbuminuria. Fractalkine is a large cytokine protein of 373 amino acids; it contains multiple domains. Fractalkine (CX3CL1) is a unique chemokine and the only representative of the CX3C group. It exists as a membrane-bound and soluble form. It interacts with cells expressing CX3CR1, a G-coupled protein receptor. It is also commonly known by the names fractalkine (in humans) and neurotactin (in mice). Aim Our study aimed to assess fractalkine levels in type 2 Egyptian diabetic patients with and without diabetic nephropathy and its role as a marker in the development of diabetic nephropathy. Patients and methods Our study was carried out on 75 individuals: 25 controls, 25 type 2 diabetic patients without diabetic nephropathy, and 25 type 2 diabetic patients with diabetic nephropathy. These patients were subjected to a full laboratory workup including fasting and postprandial blood glucose, glycated hemoglobin A1C, serum urea and creatinine, 24-h UAE, and fractalkine level. Results and conclusion Our study showed that the serum fractalkine concentration was significantly elevated in type 2 diabetic patients with nephropathy (1153.14±261.1) compared with type 2 diabetic patients without nephropathy (705.78±150.59) and the control group (251.5±64) (both P =0.000). There was a significant correlation between serum fractalkine level and 24-h UAE, HBA1C, and serum creatinine. Thus, this positive correlation between serum fractalkine level and UAE could be an early predictor of microvascular complications in diabetic patients. We can conclude that serum fractalkine plays a pathogenic role in the development of diabetic nephropathy.