E-cadherin and periostin in early detection and progression of diabetic nephropathy: epithelial-to-mesenchymal transition

  • Nada M. Qamar El-Dawla
  • Al-Aliaa M. Sallam
  • Mohamed H. El-Hefnawy
  • Hala O. El-MesallamyEmail author
Original article



Diabetic nephropathy (DN) is a severe complication of diabetes mellitus (DM). Many mechanisms are involved in its development; one of these mechanisms is epithelial-to-mesenchymal transition (EMT). During EMT, losing of the epithelial biomarkers like E-cadherin and increasing of mesenchymal biomarkers like periostin are very characteristic.


The study included 19 healthy controls and 71 DN patients categorized according to their urinary albumin-to-creatinine ratio (UACR) into 19 normoalbuminuric (UACR < 30 mg/g), 37 microalbuminuric (UACR 30–300 mg/g), and 15 macroalbuminuric (UACR > 300 mg/g) patients. Fasting plasma glucose (FPG), glycated hemoglobin (HbA1C%), serum creatinine (Cr), and urea were measured. E-cadherin and periostin were measured by ELISA and compared among groups.


Concerning E-cadherin levels, in comparison to control group, there were significantly decreased in all groups (0.94, 0.52, and 0.14 ng/mL in normoalbuminuria, microalbuminuria, and macroalbuminuria groups; respectively). For periostin levels, nonsignificant increase in normoalbuminuria (0.32 ng/mL) than control group (0.3 ng/mL) was observed. There was a significant increase in other groups with the highest values in macroalbuminuria group (1.66 ng/mL). E-cadherin and periostin were correlated with each other (r = − 0.353, P < 0.001). UACR was negatively correlated with E-cadherin and positively correlated with periostin. ROC curve analyses showed that the AUC to diagnose established microalbuminuria using E-cadherin was 0.998 (95% CI 0. 932–1), and using periostin was 0.833 (95% CI 0.709–0.919).


Serum E-cadherin and periostin could be considered as reliable biomarkers involved in DN pathogenesis and linked to its stages.


Diabetic nephropathy E-cadherin EMT Periostin 



No funding received.

Compliance with ethical standards

Conflict of interest

All the authors have declared no competing interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Human Ethical Review Committee, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt, and the NIDE, Cairo, Egypt at which the studies were conducted (Approval number 122/2015) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Japanese Society of Nephrology 2019

Authors and Affiliations

  • Nada M. Qamar El-Dawla
    • 1
  • Al-Aliaa M. Sallam
    • 2
  • Mohamed H. El-Hefnawy
    • 3
  • Hala O. El-Mesallamy
    • 2
    Email author
  1. 1.Biochemistry Department, Faculty of PharmacyModern University for Technology and InformationCairoEgypt
  2. 2.Biochemistry Department, Faculty of PharmacyAin Shams UniversityCairoEgypt
  3. 3.National Institute of Diabetes and Endocrinology (NIDE)CairoEgypt

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