Abstract
BackgroundPrevious studies have shown that a variety of biomarkers are closely related to the occurrence and development of early-stage diabetic nephropathy (DN) in patients. The aim of this study was to evaluate the role of multiple sera and urinary biomarkers in the diagnosis of early-stage DN in patients with type 2 diabetes.MethodsWe enrolled 287 patients with type 2 diabetes, who were classified into normoalbuminuria (n = 144), microalbuminuria (n = 94), or macroalbuminuria (n = 49) groups based on their urine albumin to creatinine ratios (UACR), along with 42 healthy controls. We assessed 13 biomarkers, including transferrin (Tf), immunoglobulin G (IgG), podocalyxin, neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-beta-glucosaminidase, α-1-microglobulin, 8-hydroxy-deoxyguanosine, tumor necrosis factor-alpha (TNF-α), and interleukin-18 in urine samples, along with cystatin C, total bilirubin, and uric acid in sera samples, to evaluate their diagnostic roles. From the measurements, the blood neutrophil to lymphocyte ratio was also calculated.ResultsUrinary Tf, IgG, NGAL, and TNF-α were significantly related to the UACR. We calculated the area under the receiver operating characteristic curves (area under the curve) and found that urinary IgG (0.894), NGAL (0.875), Tf (0.861), TNF-α (0.763), and the combination of urinary Tf + IgG + TNF-α + NGAL (0.922) showed good diagnostic value for early-stage DN.ConclusionsUrinary Tf, IgG, NGAL, TNF-α, and the combination of all four biomarkers demonstrated excellent diagnostic value for early-stage DN in patients with type 2 diabetes.
Highlights
Diabetic nephropathy (DN), known as diabetic kidney disease, is a common and severe microvascular complication of type 2 diabetes that can result in end-stage kidney disease
The Tf, immunoglobulin G (IgG), PCX, neutrophil gelatinase-associated lipocalin (NGAL), NAG, a1MG, 8-OHdG, tumor necrosis factor-alpha (TNF-a), IL-18, and neutrophil to lymphocyte ratio (NLR) levels of patients in the microalbuminuria group were higher than the healthy controls and normoalbuminuria groups (P < 0.05 for NLR, P < 0.001 for other parameters)
The Tf, PCX, NGAL, NAG, a1MG, total bilirubin (TBIL), and IL-18 levels in patients with normoalbuminuria were higher than the healthy controls (P < 0.001 or P < 0.05)
Summary
Diabetic nephropathy (DN), known as diabetic kidney disease, is a common and severe microvascular complication of type 2 diabetes that can result in end-stage kidney disease. The role of serum and urinary biomarkers in the diagnosis of early diabetic nephropathy in patients with type 2 diabetes. Previous studies have shown that a variety of biomarkers are closely related to the occurrence and development of early-stage diabetic nephropathy (DN) in patients. The aim of this study was to evaluate the role of multiple sera and urinary biomarkers in the diagnosis of early-stage DN in patients with type 2 diabetes. We assessed 13 biomarkers, including transferrin (Tf), immunoglobulin G (IgG), podocalyxin, neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-beta-glucosaminidase, a-1-microglobulin, 8-hydroxydeoxyguanosine, tumor necrosis factor-alpha (TNF-a), and interleukin-18 in urine samples, along with cystatin C, total bilirubin, and uric acid in sera samples, to evaluate their diagnostic roles. Conclusions: Urinary Tf, IgG, NGAL, TNF-a, and the combination of all four biomarkers demonstrated excellent diagnostic value for early-stage DN in patients with type 2 diabetes
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