Could MOTS-C Levels in Children with Type 1 Diabetes Mellitus Be an İndicator for Early Diabetic Kidney Disease?

INTRODUCTION: The aim of our study was to compare serum MOTS-c levels in children with Type 1 diabetes mellitus (T1DM) to those of healthy children. We also aimed to examine whether serum MOTS-c levels could be used as an early indicator of DKD by correlating with changes in GFR and microalbuminuria.
METHODS: We recruited 82 patients who were being treated for insulin-dependent diabetes at the outpatient pediatric endocrinology clinic. At study MOTS-c, urinary albümin excretion, eGFR, HbA1c were evaluated and diabetes-related clinical features and anthropometric measurements were collected. Patients were divided into subgroups according to diabetes duration, precence of albuminuria, glomerular hyperfiltration, eGFR decline and metabolic control.
RESULTS: The levels of MOTS-C were significantly lower in the Tip1DM group (76.2±1.3mg/dl) than in the control group (105.2±7.0, p=0.00). No significant difference in MOTS-c levels was found among the subgroups categorized by diabetes duration, obesity, metabolic control, hypertension and hyperlipidemia, glomerular hyperfiltration, decline in eGFR, and presence of microalbuminuria. The simple linear regression analysis results indicated that MOTS-C was not predictive for marker of diabetic kidney disease.
DISCUSSION AND CONCLUSION: In current study, MOTS-c was lower in the type 1DM group than in healthy children. However, the lack of association with microalbuminuria, hyperfiltration, and eGFR decline suggested that MOTS-c is not an early marker in diabetic kidney disease. This finding suggests that the onset of oxidative damage and mitochondrial dysfunction in T1DM is independent of diabetic kidney disease. Additionally, the study suggests that HBA1C and duration of diabetes are significant risk factors, while changes in eGFR and microalbuminuria continue to serve as indicators of diabetic kidney disease.