Background: Tsukushi (TSK) is a newly identified hepatokine that is associated with lipid and glucose metabolism. Although hyperglycemia, hyperlipemia and metabolic disorder are associated with diabetic nephropathy (DN) development, there is currently no investigation about whether TSK is associated with urinary albumin‐creatinine ratio (UACR) and renal function.

Methods: Serum TSK level was quantified by ELISA in 167 normoalbuminuria, 80 microalbuminuria, 31 macroalbuminuria patients with T2DM as compared with 53 healthy subjects. Multiple linear regression and logistic regression analysis were used to analyze the relationship of TSK or other characteristics with UACR and eGFR.

Results: The TSK level in the all T2DM group was prominently higher than that in the control group. Further, TSK level in macroalbuminuria group was significantly higher than normoalbuminuria and microalbuminuria. Multiple linear regression showed that high TSK quartile, systolic pressure, serum creatinine, HOMA-IR, low 2-h post-OGTT glucose and female were the significantly independent factors for UACR. Logistic regression demonstrated that the OR of TSK for eGFR ≤ 90 was 1.636 (95%CI 1.091-2.452, P=0.017).

Conclusion: The circulating TSK increased in T2D patients with albuminuria and associated with UACR and eGFR, implied that TSK may involve in the pathogenesis of DN, which deserved future studies.


Y. Y. Li: None.


Talents Training Program of Shanghai Pudong Hospital (YQ202101); Social Development Project of Jiangsu Province (BE2018692); Natural Science Foundation of Jiangsu Province (BK20191222)

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