Objective:

To examine the associations between serum adropin and diabetic kidney disease (DKD) and to provide experimental validation in a mouse model.

Approach:

• Study Population: Participants were drawn from a community-based cohort in Guankou Town, Xiamen, China, with follow-up from 2013 to 2021.
• Cross-Sectional Analysis: Evaluated associations with prevalent DKD using multivariable logistic regression and restricted cubic spline models.
• Longitudinal Analysis: Assessed incident DKD using Cox proportional hazards models and restricted cubic spline analyses.
• Animal Model: Utilized an STZ-induced DKD mouse model to assess adropin dynamics and effects of adropin administration.

Key Findings:

• Higher serum adropin was inversely associated with prevalent DKD (adjusted OR per 1-unit increase 0.83 [95% CI 0.71–0.96]).
• Among participants free of DKD at baseline, higher baseline adropin was associated with lower incident DKD risk (adjusted HR per 1-unit increase 0.88 [95% CI 0.85–0.91]).
• Serum adropin levels declined during DKD progression in mice, and adropin treatment improved renal injury indicators compared with untreated DKD controls.

Interpretation:

Serum adropin is inversely associated with both prevalent and incident DKD, suggesting a potential renoprotective role.

Limitations:

• The study is based on a community cohort, which may limit generalizability.
• Longitudinal evidence is limited to the follow-up period and may not capture long-term effects.

Conclusion:

The findings indicate an association between serum adropin and DKD, warranting further investigation.