Urinary Neutrophil Gelatinase-associated Lipocalin: As an Early Marker for Diabetic Nephropathy

Abstract

Background: Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diagnostic marker to detect diabetic nephropathy at early stage is important as early intervention can slow the loss of kidney function and reduce adverse outcomes. Neutrophil gelatinase-associated lipocalin (NGAL) is a small (25-kd) protein that belongs to the lipocalin protein family. Urinary NGAL (u-NGAL) levels have been demonstrated to be a very promising marker especially in acute kidney disease. Objective: To measure urinary neutrophil gelatinase-associated lipocalin (NGAL) as an early marker for diagnosis of diabetic nephropathy in type 2 diabetes mellitus (T2DM) patients. Patients and Methods: The study was conducted on 84 subjects, from (18- 80 years old), 45 (53.5%) were males and 39 (46.4%) were females, with mean age (58.18 ± 13.98). They were collected from Endocrinology and Nephrology Clinic after a written consent was taken from the patients at Zagazig University Hospital. Results: Urinary NGAL is higher in diabetic patients compared with non-diabetic controls with high significant difference (p < 0.0001). In our result we found a positive correlation between NGAL and the duration of DM (r =0.279, p=0.027). There was a positive correlation between NGAL level and HbA1C, with significant difference (r =0.778, p =0.000) in patients groups. Our results showed a positive correlation between NGAL and FPG (r= 0.562) (p < 0.001) and 2hPPPG (r=0.687) (p < 0.001). There was a positive correlation between NGAL level and albumin-creatinine ratio (Alb/Cr) with significant difference (r =0.888, p < 0.001) in patients groups. Conclusion: There was a high significant difference in the level of urinary NGAL in diabetic patients than control subjects. Urine NGAL had a positive correlation with albumin-creatinine ratio, duration of DM, HbA1c.