Predictive and diagnostic value of MCP-1, MIF, and ICAM-1 in Type-2 diabetes mellitus patients with diabetic kidney disease.

OBJECTIVE

To explore the predictive value of monocyte chemoattractant protein-1 (MCP-1), macrophage migration inhibitory factor (MIF), and intercellular adhesion molecule-1 (ICAM-1) in patients with Type-2 diabetes mellitus (T2DM) complicated by diabetic kidney disease (DKD).

METHODS

This cross-sectional retrospective study included T2DN patients admitted to the Nephrology Department of Lanzhou University Second Hospital from September, 2022 to March, 2024. DKD was assessed by measuring the ratio of urinary albumin to creatinine. A Receiver Operating Characteristic (ROC) analysis was performed to evaluate the predictive value of MCP-1, MIF, and ICAM-1 for DKD.

RESULTS

A total of 241 patients were included, predominantly 158 males (65.6%), with a median age of 60 (53-69) years. Sixty-seven patients had no DKD (normal proteinuria), while 174 patients presented with DKD; of them, 95 cases had microalbuminuria, and 79 cases had high proteinuria. The MCP-1, MIF, and ICAM-1 levels in the high-proteinuria group were significantly higher than in other groups (all P<0.05). The multivariate logistic regression analysis showed that high levels of MCP-1, MIF, and ICAM-1 are risk factors for the development of DKD. ROC analysis demonstrated that the area under the curve (AUC) of MCP-1, MIF, and ICAM-1 for diagnosing DKD were 0.895 (95% CI: 0.857-0.933, P<0.001), 0.719 (95% CI: 0.653-0.785, P<0.001), and 0.827 (95% CI: 0.773-0.880, P<0.001), respectively. The combined prediction of DKD by the three factors was 0.941 (95% CI: 0.914-0.968, P<0.001).

CONCLUSIONS

MCP-1, MIF, and ICAM-1 are risk factors for developing DKD. A combination of these indexes may have a good predictive value for DKD.