The following is a summary of “Urinary sphingolipids in adolescents and young adults with youth-onset diabetes,” published in the January 2024 issue of Nephrology by Nehus et al.

Researchers started a retrospective study to assess whether urinary sphingolipid levels could serve as an early indicator of diabetic kidney disease (DKD) in young people with type 1 and 2 diabetes.

They analyzed urinary sphingolipids, including sphingomyelin (SM), glucosylceramide (GC), ceramide (Cer), and lactosylceramide (LC) species, in participants from the SEARCH for Diabetes in Youth cohort who had youth-onset diabetes. Sphingolipid levels, normalized to urine creatinine, were compared among 57 individuals with type 1 diabetes, 59 with type 2 diabetes, and 44 HCs. Assessed the relationship between sphingolipids and albumin-to-creatinine (ACR) ratio and estimated glomerular filtration rate (eGFR).

The results showed 23.1 years (median age) with IQR: 20.9, 24.9 and a median diabetes duration (9.3 years, IQR: 8.5, 10.2). Urinary sphingolipid concentrations were significantly higher in patients with diabetic kidney disease (DKD, ACR ≥ 30 mg/g) compared to healthy controls. No significant differences in sphingolipid levels were observed between type 1 and type 2 diabetes participants. In multivariable analysis, several sphingolipid species correlated positively with ACR, with notable associations for C18 SM, C24:1 SM, C24:1 GC, and C24:1 Cer (all P<0.001). Sphingolipid levels were unrelated to eGFR, yet significant interaction terms (diabetes type*sphingolipid) hinted at diabetes type potentially modifying the sphingolipid-eGFR association.

They concluded that young diabetics exhibit elevated urinary sphingolipids linked to albumin excretion, suggesting their potential as early DKD biomarkers.

Source: link.springer.com/article/10.1007/s00467-023-06257-6