Estimation of Some Biomarkers in Type 2 Diabetic Patients for Detection Early Incidence of Diabetic Nephropathy

Alyaa Kadhim  Hliel; Huda Farhan  Ahmed; Hiba  Abdul-Hussein

doi:10.18502/acta.v63i3.19718

Alyaa Kadhim Hliel Department of Medical Laboratory Sciences Technology, College of Health and Medical Techniques, Middle Technical University, Baghdad, Iraq
Huda Farhan Ahmed Department of Medical Laboratory Sciences Technology, College of Health and Medical Techniques, Middle Technical University, Baghdad, Iraq
Hiba Abdul-Hussein Department of Medical Laboratory Sciences Technology, College of Health and Medical Techniques, Middle Technical University, Baghdad, Iraq

DOI: https://doi.org/10.18502/acta.v63i3.19718

Keywords: Diabetes mellitus type 2; Diabetic nephropathy; Nephrin; Wnt Inducible Signaling Protein-1; Transforming growth factor-β

Abstract

Diabetic Nephropathy (DN), is the major microvascular complications of diabetes, affecting 40% of type 2 diabetic patients, is the leading cause of end-stage renal failure. Microalbuminuria has a limited diagnostic role in early-stage diabetic nephropathy, because renal damage usually occurs before proteinuria. Therefore, more sensitive and specific biomarkers are needed for early detection of Diabetic Nephropathy. A Case-control study involved 180 participants aged 40-≥70 year, 60 individuals are healthy, 120 person with type 2 diabetes mellitus (T2DM), they were divided in three groups by urinary albumin/ creatinine ratio (ACR). Group 1:40 patients with normo albuminuria (ACR<30 mg/g). Group 2: 40 patients with micro albuminuria (ACR 30-300 mg/g). Group 3: 40 patients with macro albuminuria (ACR˃300 mg/g). Nephrin, transforming growth factor-β (TGF-β) and Wnt inducible signaling pathway protein1 (WISP1) was estimated in serum by an enzyme-linked immunosorbent assay (ELISA); also fasting blood sugar, glycated hemoglobin, blood urea and serum creatinine was determined by enzymatic method, urine albumin/creatinine ratio determined by measurements of albumin and creatinine in urine sample. There was a significant elevation for all parameters in the patients compared to healthy control but eGFR decrease. The prevalence of diabetic nephropathy was found in male more than female and the majority of patients were in age group 60-≥70 years. A significant difference in mean±SD of age, Body Mass Index (BMI), and duration of diabetes, macro albuminuria, microalbuminuria, and normoalbuminuria groups show a statistically higher S. Nephrin, TGF-β and WISP1 in comparison to control. Nephrin and TGF- β have a strong association with blood urea, serum creatinine and an inverse association with glomerular filtration rate in all diabetic groups. While there were significant positive correlations between the WISP1 with urea. In contrast there was positive correlations with creatinine only in micro- and macro albuminuria groups, while no correlation with eGFR. In Receiver operating characteristic (ROC) curve analysis, nephrin, WISP1 and TGF- β showed high sensitivity and specificity. Elevated levels of Nephrin, WISP1 and TGF-β in type 2 diabetic patients have been reported in the current study. These findings proposed that nephrin, WISP1 and TGF- β could be an early diagnostic marker for DN detection.