Relative Hypoxia and Early Diabetic Kidney Disease in Type 1 Diabetes.
Authors Vinovskis C, Li LP, Prasad P, Tommerdahl K, Pyle L, Nelson RG, Pavkov ME, van
Raalte D, Rewers M, Pragnell M, Mahmud FH, Cherney DZ, Johnson RJ, Nadeau KJ,
Bjornstad P
Submitted By Petter Bjornstad on 8/11/2020
Status Published
Journal Diabetes
Year 2020
Date Published 7/1/2020
Volume : Pages Not Specified : Not Specified
PubMed Reference 32737116
Abstract The objective of this study was to compare the ratio of renal oxygen
availability (RO2) to GFR (RO2:GFR), a measure of relative renal hypoxia, in
adolescents with and without type 1 diabetes (T1D) and relate the ratio to
albuminuria, renal plasma flow (RPF), fat mass, and insulin sensitivity (M/I).
RO2 was estimated by blood oxygenation level dependent (BOLD) MRI, fat mass by
DXA, GFR and RPF by iohexol and p-aminohippurate clearance, albuminuria by urine
albumin-to-creatinine ratio (UACR), and M/I from steady-state glucose infusion
rate/insulin (mg/kg/min) by hyperglycemic clamp in 50 adolescents with T1D
(16.1±3.0 years, HbA1c 8.6±1.2%) and 20 controls of similar BMI (16.1±2.9 years,
HbA1c 5.2±0.2%). The RO2:GFR (ms/ml/min) was calculated as renal oxygen
availability (T2*, ms) divided by GFR (ml/min). Whole-kidney RO2:GFR was 25%
lower in adolescents with T1D vs. controls (p<0.0001). In adolescents with T1D,
lower whole-kidney RO2:GFR associated with higher UACR (r=-0.31, p=0.03), RPF
(r=-0.52, p=0.0009) and fat mass (r=-0.33, p=0.02). Lower medullary RO2:GFR
associated with lower M/I (r=0.31, p=0.03). In conclusion, adolescents with T1D
exhibited relative renal hypoxia that associated with albuminuria, increased
RPF, fat mass, and insulin resistance. These data suggest a potential role of
renal hypoxia in the development of DKD.