D3.390 - Lipopolysaccharide-Binding Protein And sCd14 In Patients With Type 1 Diabetes Mellitus And Diabetic Nephropathy

Diabetic nephropathy (DN) is one of the most severe complications of type 1 diabetes mellitus (DM1), DN pathogenesis  is associated with chronic inflammation and systemic endotoxemia. Lipopolysaccharide-binding protein (LBP) and soluble CD14 (sCD14), which are participants in the interaction of LPS with Toll-like receptor 4 (TLR4), play a key role in the biological effects of lipopolysaccharide (LPS).

The study included 92 patients with DM1, divided into two groups: DM1 without DN (n=19) and DM1 with DN (n=73). The levels of LDL, sCD14, C-reactive protein (CRP), glycated hemoglobin (HbA1c), microalbuminuria, urea, and creatinine were determined.

Patients with DN showed a significant decrease in sCD14 levels of 8.85 (7.0–10.5) pg/ml versus 15.6 (10.5–53.2) pg/ml; p=0.012. The HbA1c level in the group with DN was lower - 8.15% (7.11–9.55) versus 11.2% (7.6–11.8); p=0.038. The level of LBP did not significantly differ between the groups (p=0.177).

A decrease in sCD14 levels is associated with the development of DN in patients with DM1. Levels of CRP and LBP did not differ significantly between the groups. This  indicates the development of endotoxin tolerance against the background of low-intensity LPS-induced inflammation, which may subsequently be accompanied by the progression of vascular complications.