The Clinical Value of Serum Adropin Level in Early Detection of Diabetic Nephropathy

Abstract

Background/Aims: Adropin is a metabolic hormone secreted by the liver, brain, and many peripheral tissues and is involved in energy homeostasis and insulin sensitivity. Some reports have indicated a significant decrease in serum adropin levels in type 2 diabetic patients. However, the significance of a decline in adropin level in early detection of diabetic nephropathy (DN) remains to be clarified. The purpose of this study was to evaluate the serum levels of adropin in patients with type 2 diabetes with and without nephropathy. Methods: A total of 135 unrelated subjects (including 45 diabetic patients with nephropathy, 45 without nephropathy, and 45 healthy controls) were enrolled in this study. Fasting venous blood samples were collected from all patients. Serum adropin levels of all cases were analyzed by an enzyme-linked immunosorbent assay method. The correlations of serum adropin levels with anthropometric and biochemistry variables were determined. Logistic regression was performed to assess the association of adropin with odds of nephropathy. A receiver operating characteristic (ROC) curve was obtained to explore the optimum serum adropin concentration in distinguishing diabetic patients with and without nephropathy. Results: Diabetic patients with nephropathy showed lower serum adropin levels than those in patients without nephropathy and healthy controls (p < 0.001). Pearson correlation analysis indicated that serum adropin was negatively correlated with BMI, FBS, HbA1c, blood urea, creatinine, LDL, and ACR and positively correlated with HDL and albumin. Logistic regression analysis showed that serum adropin was correlated with decreased risk of developing diabetic nephropathy. Moreover, in ROC analysis, at cutoff value 3.20 (mg/dL) with an AUC = 0.830, adropin had 80% sensitivity and 60% specificity for distinguishing the diabetic nephropathy. Conclusions: This study demonstrates that decreased level of adropin is associated with renal dysfunction in patients with type 2 diabetes mellitus. Serum adropin concentrations may be used as a biomarker for early detection of diabetic nephropathy.