The role of endothelial biomarkers in predicting damp-heat syndrome in diabetic kidney disease

Objective: To explore the role of endothelial biomarkers in predicting damp-heat syndrome in diabetic kidney disease (DKD). Methods: A total of 183 patients with DKD were divided into 3 groups: the early DKD group, established DKD group, and advanced DKD group. All patients were classified according to traditional Chinese medicine (TCM) syndrome type, and clinical indexes were collected for statistical analysis. Results: A total of 183 DKD patients were included in this study. Fibroblast growth factor 23 (FGF23), chitinase-3-like protein 1 (CHI3L1), endocan, tumor necrosis factor receptor 1 (TNFR1), secretory leukocyte protease inhibitor (SLPI), and vascular endothelial growth factor A (VEGF-A) were increased in advanced DKD. FGF23, CHI3L1, endocan, SLPI, and TNFR1 showed a negative correlation with estimated glomerular filtration rate (eGFR), while they had a positive correlation with 24 h urine protein. After adjusting for age, gender, diabetes duration, body mass index (BMI), hemoglobin, glucose, uric acid, 24 h urine protein, cholesterol, triglyceride, low-density lipoprotein, and hemoglobin A1c (HbA1c), the multiple regression analysis showed that FGF23, endocan, TNFR1, and SLPI significantly correlated with eGFR. Conclusions: FGF23, endocan, TNFR1, and SLPI are elevated in advanced DKD compared with early stage, and they may take part in the pathogenesis and progression of DKD. Our study provides useful biomarkers for predicting the appearance of damp-heat syndrome, including FGF23, endocan, TNFR1, and SLPI.