Relationships between serum MCP-1 and subclinical kidney disease: African American-Diabetes Heart Study

Background: Monocyte chemoattractant protein-1 (MCP-1) plays important roles in kidney disease susceptibility and atherogenesis in experimental models. Relationships between serum MCP-1 concentration and early nephropathy and subclinical cardiovascular disease (CVD) were assessed in African Americans (AAs) with type 2 diabetes (T2D). Methods: Serum MCP-1 concentration, urine albumin: creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), and atherosclerotic calcified plaque (CP) in the coronary and carotid arteries and infrarenal aorta were measured in 479 unrelated AAs with T2D. Generalized linear models were fitted to test for associations between MCP-1 and urine ACR, eGFR, and CP. Results: Participants were 57% female, with mean +/- SD (median) age 55.6 +/- 9.5 (55.0) years, diabetes duration 10.3 +/- 8.2 (8.0) years, urine ACR 149.7 +/- 566.7 (14.0) mg/g, CKD-EPI eGFR 92.4 +/- 23.3 (92.0) ml/min/1.73m(2), MCP-1 262.9 +/- 239.1 (224.4) pg/ml, coronary artery CP 280.1 +/- 633.8 (13.5), carotid artery CP 47.1 +/- 132.9 (0), and aorta CP 1616.0 +/- 2864.0 (319.0). Adjusting for age, sex, smoking, HbA(1c), BMI, and LDL, serum MCP-1 was positively associated with albuminuria (parameter estimate 0.0021, P=0.04) and negatively associated with eGFR (parameter estimate -0.0003, P=0.001). MCP-1 remained associated with eGFR after adjustment for urine ACR. MCP-1 levels did not correlate with the extent of CP in any vascular bed, HbA(1c) or diabetes duration, but were positively associated with BMI. No interaction between BMI and MCP-1 was detected on nephropathy outcomes. Conclusions: Serum MCP-1 levels are associated with eGFR and albuminuria in AAs with T2D. MCP-1 was not associated with subclinical CVD in this population. Inflammation appears to play important roles in development and/or progression of kidney disease in AAs.