Impact of Procollagen III Amino Terminal Peptide and Laminin on Nephropathy in Pre-Diabetic and Type 2 Diabetic Patients

Amanj Zrar  Hasan; Mohammed I.  Hamzh; Mahmood Shakir  Khudhair

doi:10.18502/acta.v64i4.21983

Amanj Zrar Hasan College of Medicine, Al-Nahrain University, Baghdad, Iraq
Mohammed I. Hamzh College of Medicine, Al-Nahrain University, Baghdad, Iraq
Mahmood Shakir Khudhair College of Medicine, Al-Nahrain University, Baghdad, Iraq

DOI: https://doi.org/10.18502/acta.v64i4.21983

Keywords: Laminin (LM); Procollagen III N‑terminal peptide (PIIINP); Urine albumin-creatinine ratio (UACR); Pre-diabetes; Diabetes nephropathy

Abstract

Chronic hyperglycemia is one of the most prevalent causes of the development of type 2 diabetes mellitus (T2DM) worldwide, with diabetic nephropathy (DN) being the principal microvascular complication. Laminin is a major non‑collagenous glycoprotein that is an important component of all basement membranes. Serum PIIINP is a precursor of collagen III associated with several inflammatory disorders and tissue fibrosis, including liver and kidney fibrosis. The aim of this study was to assess and compare the concentrations of Laminin (LM), Procollagen III N‑terminal Peptide (PIIINP), and various biochemical parameters in individuals diagnosed with type 2 diabetes, both with and without nephropathy, alongside control subjects, in order to explore the potential of LM and PIIINP as predictive biomarkers for early detection in these patients. A case‑control study was conducted from March 2024 to October 2024. The study included 180 participants (93 females and 87 males) consisting of four groups: Group 1 (45) healthy participants, Group 2 (45) participants with prediabetes, Group 3 (40) T2DM patients with normoalbuminuria, and Group 4 (50) T2DM patients with nephropathy (microalbuminuria and macroalbuminuria). The study was conducted at Al‑Imamin Al‑Kadhimeen City Hospital. Our study showed that the serum concentration of laminin in patients with type 2 diabetes mellitus with nephropathy (560.60±66.85 pg/ml) was significantly elevated compared with individuals with type 2 diabetes without nephropathy (359.60±29.83 pg/ml), prediabetes (140.00±19.72 pg/ml), and healthy subjects (113.90±29.65 pg/ml) (P<0.001). Additionally, the mean serum PIIINP value was significantly higher in type 2 diabetes patients with nephropathy (660.90±47.67 pg/ml) compared to those without nephropathy (521.60±80.00 pg/ml), prediabetes (437.80±75.00 pg/ml), and controls (360.30±57.50 pg/ml) (P<0.001). There was no correlation between LM and PIIINP in prediabetes; however, there was a substantial positive correlation between laminin and PIIINP in type 2 diabetes with nephropathy (r=0.67, P<0.001) and in type 2 diabetes without nephropathy (r=0.36, P<0.014).