High serum Isthmin-1 as a biomarker of chronic kidney disease progression in patients with type 2 diabetes mellitus

Objectives To determine the relationship between serum Ism-1 levels and chronic kidney disease (CKD) progression in patients with T2DM. Methods This prospective longitudinal study included 223 patients with T2DM. Patients were divided into quartiles according to serum Ism-1 levels. A Cox proportional hazards ratio model was applied to analyze the relationship between CKD progression and serum Ism-1 levels. Results A total of 197 patients were finally analyzed, and the mean length of follow-up was 40.86 months. The serum Ism-1 levels were associated with eGFR decline and an increased risk of composite renal outcomes after adjusting for age, gender, body mass index, diabetes duration, history of hypertension, fasting blood glucose, fasting C-peptide, total cholesterol, triglycerides, drinking, smoking and follow-up period (all P  < 0.05). However, the predictive ability of Ism-1 for composite renal outcomes disappeared after adjusting for baseline eGFR in Cox regression analysis and receiver operating characteristic (ROC) curve analysis. Conclusions High serum Ism-1 may be a biomarker for CKD progression in patients with T2DM.