Background and Aims: Galectin-3 is a broad-spectrum biological response modifier and belongs to the multifunctional galectin family. It is involved in tissue fibrosis, immunity, and inflammatory response and recent evidence suggests that galectin-3 is associated with chronic kidney disease (CKD) in both diabetic and nondiabetic populations. We therefore aim to determine whether serum galectin-3 level is associated with rapid kidney function decline in type 2 diabetic individuals without overt nephropathy.

Methods: Galectin-3 was measured in the baseline samples by ELISA in 998 type 2 diabetic patients with estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73m2 and no macroalbuminuria. Rapid renal progression during follow up was defined as a rate of eGFR decline >5 ml/min/year according to Kidney Disease Improving Global Outcomes (KDIGO) Guideline.

Results: Over a median follow up of 12 years, 91 subjects had eGFR decline >5 ml/min/year and they had significantly higher serum galectin-3 level than those with more stable renal function (8.52 ± 2.20 ng/ml vs. 7.58 ± 2.38 respectively, p<0.01). In an unadjusted model, serum galectin-3 was associated with rapid decline in kidney function [hazard ratio (HR) 1.16, 95% CI 1.07-1.26, p<0.001]. Serum galectin-3 remained a significant independent predictor even after adjustment for age, gender, body mass index, smoking, baseline eGFR, systolic blood pressure, HbA1c and duration of diabetes, the presence of microalbuminuria and renin-angiotensin system blockers therapy (p=0.004).

Conclusion: In type 2 diabetic subjects without overt nephropathy, serum galectin-3 was a significant independent risk factor for rapid decline in kidney function.


K.C.B. Tan: None. C. Lee: None. Y. Wong: None. S. Shiu: None.

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