Serum Prokineticin 2 Levels Correlate with Diabetic Kidney Disease in Patients with Type 2 Diabetes

Introduction: Prokineticin 2 (PROK2) is a secreted protein, that plays a critical role in the circadian regulation of energy homeostasis. However, its association with type 2 diabetes mellitus (T2DM) and diabetes-related complication remains poorly understand. This study aimed to investigate the relationship between serum PROK2 levels, T2DM and diabetic kidney disease (DKD). Methods A total of 255 participants were enrolled, including 40 healthy controls and 215 patients with T2DM. DKD was defined as a urinary albumin-to-creatinine ratio (UACR) ≥ 0.03 g/g, or an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m². Serum PROK2 concentrations were quantified using enzyme-linked immunosorbent assay. Binary logistic regression models were applied to evaluate the associations between PROK2 levels and the risks of T2DM and DKD. Correlation analyses were performed to assess the relationships between PROK2 and renal function indicators, including UACR and eGFR. Results Serum PROK2 levels differed significantly among the study groups ( P  < 0.05), with the lowest concentrations observed in patients with DKD. After adjustment for potential confounders, higher serum PROK2 levels were independently associated with a lower risk of T2DM (odds ratio [OR] = 0.492, P  = 0.001) and DKD (OR = 0.679, P  = 0.046). Furthermore, PROK2 levels were negatively correlated with UACR ( r =–0.212, P  = 0.0007) and positively correlated with eGFR ( r  = 0.271, P  < 0.0001). Conclusion Serum PROK2 levels are significantly reduced in patients with T2DM, particularly among those with DKD. These findings suggest that PROK2 may serve as a novel circulating biomarker for assessing renal impairment in individuals with T2DM.