Abstract
Introduction:Although microalbuminuria remains the gold standard for early detection of diabetic nephropathy (DN), it is not a sufficiently accurate predictor of DN risk. Thus, new biomarkers that would help to predict DN risk earlier and possibly prevent the occurrence of end-stage kidney disease are being investigated.Objective:To investigate the role of zinc-alpha-2-glycoprotein (ZAG) as an early marker of DN in type 2 diabetic (T2DM) patients.Methods:88 persons were included and classified into 4 groups: Control group (group I), composed of normal healthy volunteers, and three patient groups with type 2 diabetes mellitus divided into: normo-albuminuria group (group II), subdivided into normal eGFR subgroup and increased eGFR subgroup > 120 mL/min/1.73m2), microalbuminuria group (group III), and macroalbuminuria group (group IV). All subjects were submitted to urine analysis, blood glucose levels, HbA1c, liver function tests, serum creatinine, uric acid, lipid profile and calculation of eGFR, urinary albumin creatinine ratio (UACR), and measurement of urinary and serum ZAG.Results:The levels of serum and urine ZAG were higher in patients with T2DM compared to control subjects and a statistically significant difference among studied groups regarding serum and urinary ZAG was found. Urine ZAG levels were positively correlated with UACR. Both ZAG levels were negatively correlated with eGFR. Urine ZAG levels in the eGFR ˃ 120 mL/min/1.73m2 subgroup were higher than that in the normal eGFR subgroup.Conclusion:These findings suggest that urine and serum ZAG might be useful as early biomarkers for detection of DN in T2DM patients, detectable earlier than microalbuminuria.
Highlights
Microalbuminuria remains the gold standard for early detection of diabetic nephropathy (DN), it is not a sufficiently accurate predictor of DN risk
Urine ZAG levels in the eGFR 120 mL/ min/1.73m2 subgroup were higher than that in the normal eGFR subgroup. These findings suggest that urine and serum ZAG might be useful as early biomarkers for detection of DN in type 2 diabetes mellitus (T2DM) patients, detectable earlier than microalbuminuria
Our results showed that there was no significant difference among groups regarding age, weight, and sex while there was a significant difference regarding the duration of diabetes mellitus (Table 1)
Summary
Microalbuminuria remains the gold standard for early detection of diabetic nephropathy (DN), it is not a sufficiently accurate predictor of DN risk. Diabetic nephropathy is associated with mortality and morbidity in patients with diabetes mellitus.[1] The most common method of detecting the early signs of diabetic nephropathy is the measurement of microalbuminuria.[2] pathological abnormalities have been reported to occur before the onset of microalbuminuria.[3] In chronic cases of diabetic nephropathy, renal function correlates better with the degree of tubulointerstitial injury rather than with glomerular lesions, suggesting that researchers should look for tubular biomarkers in order to identify patients with diabetic nephropathy.[4] There has been an increasing interest in identifying other biomarkers that might give a sensitive and rapid means of detecting the progression of diabetic nephropathy In this aspect, biomarkers that reflect tubular damage have been suggested by many investigators.[5,6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
