Elabela levels in patients with type 2 diabetes: can it be a marker for diabetic nephropathy?

Abstract

Backround: Elabela (ELA) is a hormone that is secreted at high levels in the kidneys of a healthy adult. This study aims to investigate whether serum ELA levels of patients with Type 2 Diabetes vary with the severity of renal damage.
 Methods: Our study included 50 healthy control subjects and 100 diabetic patients, who were categorized into groups based on urine albumin/creatinine ratios (ACR). Patients included in the study were assigned to four groups: Group 1 (healthy control), Group 2 (ACR<29mg/g), Group 3 (ACR=30-299 mg/g), and Group 4 (ACR>300 mg/g normal or high serum creatinine). Physical examination findings, demographic characteristics of the study group were recorded, and serum ELA levels and other laboratory parameters were assessed using appropriate methods.
 Results: The results of the study indicated that ELA levels determined in healthy individuals gradually decreased through stages of normal albuminuria, microalbuminuria, and macroalbuminuria. Moreover, ELA had a significant negative corre- lation with LDL-C (r=-0.201, p=0.014), glucose (r=-0.437, P<0.001), retinopathy (r=-0.222, P=0.006), serum BUN (r=- 0.161, P=0.049), and a positive correlation with eGFR (r=0.250, P=0.002).
 Conclusions: The fact that ELA levels are higher in healthy individuals compared to diabetic patients without microalbu- minuria, and higher in diabetic patients without microalbuminuria compared to patients with advanced albuminuria and kidney damage, suggests that the ELA level can be an important clinical prognostic variable and even a promising agent for the treatment of diabetic nephropathy patients.
 Keywords: Elabela, diabetes, diabetic kidney disease, albuminuria.

The Role of Apelin–APJ System in Diabetes and Obesity

“…Particularly, the serum Elabela level decreased progressively with the progression of DN; moreover, the serum Elabela level has a negative correlation with blood pressure, retinopathy, serum creatinine, and urinary albumin/creatinine ratio and has a positive correlation with the estimated glomerular filtration rate (29). A similar result was also confirmed by Erhan et al They found that the Elabela level was higher in healthy individuals when compared with diabetic patients without microalbuminuria and even higher in diabetic patients without microalbuminuria when compared to patients with advanced albuminuria (35). These results suggest that Elabela may be an important clinical prognostic marker.…”

“…It is reported that Elabela can ameliorate apoptosis via regulating the mitochondrial function ( 33 ). Recently, Elabela has been demonstrated to decrease kidney injury ( 34 ), and serum Elabela level in type 2 diabetes patients is closely related to the severity of renal injury ( 35 ). In addition, Elabela has been reported to improve endothelial cell function via the PI3K/Akt signaling pathway ( 36 ).…”

Elabela Attenuates the TGF-β1-Induced Epithelial-Mesenchymal Transition of Peritoneal Mesothelial Cells in Patients Receiving Peritoneal Dialysis

“…In patients with stable angina pectoris and atrial fibrillation in stable disease, ELA levels will be reduced ( Cui et al, 2021 ; Diakowska et al, 2021 ). Further, compared with healthy people, serum ELA is lower in patients with diabetic nephropathy ( Onalan et al, 2020 ). In patients with CKD, the serum ELA level gradually decreases with the reduced GFR level, with the lowest values observed in patients with CKD5 ( Lu et al, 2020 ).…”

Potential Therapeutic Role for Apelin and Related Peptides in Diabetes: An Update

“… 74 An additional study conducted in 50 healthy and 100 diabetic patients found a similar negative correlation between serum ELABELA and urinary albumin creatinine ratio. 75 …”