Early Detection Of Diabetic Nephropathy Research Articles

Association between albuminuria and retinal microvascular parameters measured with swept-source optical coherence tomography angiography in patients with diabetic retinopathy.

To evaluate the relationship between urine albumin excretion (UAE) and retinal microvascular parameters assessed using swept-source optical coherence tomography angiography (SS-OCTA) in patients with diabetic retinopathy (DR). This retrospective cross-sectional study included 180 patients with diabetes and 50 age-matched controls. Patients with diabetes were grouped according to the five-stage DR severity, combined with the presence of albuminuria. All subjects underwent 12×12mm2 field SS-OCTA. The foveal avascular zone metrics, vessel density, and capillary nonperfusion area (NPA) were quantified using a semi-automatic software algorithm on three different rectangular fields (3×3 mm2, 6×6 mm2, and 10×10 mm2). The correlations between albuminuria and the four OCTA parameters were analyzed. A total of 105 subjects had normal UAE, and 75 subjects had albuminuria. Of the 102 subjects whose DR severity was higher than mild non-proliferative DR (NPDR), capillary NPA on the 3×3 mm2, 6×6 mm2, and 10×10 mm2 fields was significantly larger in the albuminuria group. None of the OCTA parameters were significantly different between the two groups in subjects with mild NPDR or without DR. Multiple logistic regression analysis showed that an increase in NPA in the 6×6 mm2 and 10×10 mm2 fields was a significant risk factor for the presence of albuminuria (odds ratio = 1.92 and 1.35). An increase in capillary NPA was independently associated with albuminuria in patients with clinically significant DR levels. SS-OCTA imaging can be a useful marker for the early detection of diabetic nephropathy.

Serum Pentraxin-3 as a Potential Biomarker for Early Detection of Diabetic Nephropathy in Type 2 Diabetes Mellitus: A Cross-Sectional Study

This cross-sectional study aimed to assess the utility of serum Pentraxin-3 (PTX-3) as a biomarker for the early identification of diabetic nephropathy (DN) in patients with Type 2 Diabetes Mellitus (T2DM). A total of 90 participants, including 30 with T2DM and nephropathy, 30 with T2DM but without nephropathy, and 30 controls, were enrolled. Serum PTX-3 levels were measured, and correlations with clinical parameters were analyzed. The results revealed a significant elevation in serum PTX-3 levels in DN patients with T2DM. PTX-3 exhibited positive correlations with age, disease duration, blood urea, and serum creatinine, indicating its potential relevance to DN development and renal function. Conversely, non-significant negative correlations were observed with BMI and estimated glomerular filtration rate (eGFR). These findings suggest that serum PTX-3 could serve as a valuable biomarker for the early detection of diabetic nephropathy in Type 2 Diabetes Mellitus, potentially aiding in timely intervention and improved patient care.
 Highlights : 
 
 
 
 
 
 
 
 
 
 
 
 
 Serum PTX-3 levels significantly elevated in Type 2 Diabetes patients with nephropathy, highlighting its potential as an early diagnostic biomarker.
 Positive correlations observed between PTX-3, age, disease duration, blood urea, and serum creatinine, suggesting its relevance to DN development and renal function.
 Serum PTX-3 holds promise for timely identification of diabetic nephropathy, facilitating improved patient care.
 
 Keywords : Diabetic Nephropathy, Pentraxin-3, Type 2 Diabetes, Biomarker. Early Detection
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Application of urinary N-acetyl-β-D-glucosaminidase combined with serum retinol-binding protein in early detection of diabetic nephropathy.

Diabetic nephropathy (DN) is a microangiopathy of type 2 diabetes mellitus (T2DM), which can damage the kidney through various ways and mechanisms due to the nature of the disease, involving the renal interstitium and glomeruli. However, in the early stage of the disease, patients only showed kidney volume increase and glomerular hyperthyroidism, and typical symptoms that are difficult to arouse individual attention were noticed. To observe the expression of serum retinol-binding protein (RBP) and urinary N-acetyl-β-D-glucosaminidase (NAG) in patients with DN, and to analyze their value in disease prediction, so as to provide new targets for early diagnosis and treatment of DN. The baseline data of 50 T2DM patients treated in our hospital between January 2021 and December 2022 were retrospectively reviewed and included in group A. The baseline data of 50 patients with type 2 DN admitted to our hospital during the same period were collected and included in group B. The baseline data and serum RBP and urine NAG expression were compared between the two groups to analyze their value in the early prediction of DN. There was no significant difference in age, gender, duration of diabetes, combined hyperlipidemia and combined hypertension between the two groups (P > 0.05); the expression of urinary NAG and serum RBP in group B was higher than that in group A, and the difference was statistically significant (P < 0.05); a multiple logistic regression model was established, and the results showed that urinary NAG and serum RBP were related to the presence or absence of injury in diabetic patients, and overexpression of urinary NAG and serum RBP may be risk factors for renal injury in T2DM patients (OR > 1, P < 0.05); receiver operating curve curve was plotted, and the results showed that the area under the curve of urinary NAG and serum RBP expression alone and in combination for predicting DN was > 0.80, and the predictive value was satisfactory; bivariate Spearman linear correlation analysis showed that there was a positive correlation between urinary NAG and serum RBP expression in patients with DN (r = 0.566, P = 0.000). The increased expression of urinary NAG and serum RBP may be the risk factors leading to the progression of T2DM to DN. The possibility of DN can be considered in patients with urinary NAG and serum RBP overexpression by examining the expression of urinary NAG and serum RBP in patients with T2DM in clinical practice.

Elevated Level of Glycated KQTALVELVK Peptide of Albumin Is Associated with the Risk of Diabetic Nephropathy.

Diabetic nephropathy is a leading cause of end-stage renal disease. Hence, early detection of diabetic nephropathy is essential to mitigate the disease burden. Microalbuminuria, the currently used diagnostic marker of diabetic nephropathy, is not efficient in detecting it at an early stage. Therefore, we explored the utility of glycated human serum albumin (HSA) peptides for risk prediction of diabetic nephropathy. Three glycation-sensitive HSA peptides, namely, FKDLGEENFK, KQTALVELVK, and KVPQVSTPTLVEVSR, with deoxyfructosyllysine (DFL) modification were quantified by targeted mass spectrometry (MS) in a study population comprising healthy and type II diabetes subjects with and without nephropathy. Mass spectrometry, receiver operating characteristic (ROC) curve, and correlation analysis revealed that the DFL-modified KQTALVELVK peptide was better than other glycated HSA peptides and HbA1c for identifying diabetic nephropathy. DFL-modified KQTALVELVK could be a potential marker for risk prediction of diabetic nephropathy.

Abstract #1405590: Resistive Index (RI) on Renal Doppler as an Early Marker for Detecting Diabetic Nephropathy (DN)

This study was carried out to find out Resistive Index (RI) on Renal Doppler as an early marker for detecting DN and also to find out sensitivity of RI for early detection of Diabetic nephropathy. It’s a case control study of 100 patients age >18 years Study group included 50 diabetic patients with microalbuminuria and 50 diabetic patients without microalbuminuria constituted controls. Detailed clinical history and microvascular complications were recorded. All patients underwent Renal Doppler by single operator on ultrasound GE Voluson E8 with 3.5 Htz probe and RI was assessed. Proportion of patients with RI >0.7 was significantly higher in Study group as compared to controls. Mean ± SD of RI in study group was 0.72 ± 0.06, which was significantly higher as compared to control (0.61 ± 0.04). (p value <0.0001). The patients who had diabetic nephropathy, 70.00% of patients had resistive index >0.7. If resistive index was >0.7, then there was 100.00% probability of diabetic nephropathy and if resistive index< =0.7, then there were 76.92% chances of absence of diabetic nephropathy. Significant positive correlation was seen between resistive index with urine albuminuria (mg/dL) having correlation coefficient of 0.414. The present study points to significant increase in intrarenal arterial RI on renal doppler among diabetic nephropathy patients, when compared to diabetics without nephropathy. So, RI on renal doppler can be used as early, sensitive marker for detection of diabetic nephropathy.

Serum fatty acid-binding protein 4 as a biomarker for early detection of diabetic nephropathy in type 2 diabetes

BackgroundDiabetic nephropathy (DN) is one of the major causes of ESKD, and its complications are characterized by proteinuria, decreased glomerular filtration, and renal fibrosis resulting in the deterioration of renal functions, so early detection of nephropathy is essential to slow down and prevent the progression of the disease. Fatty acid-binding protein 4 (FABP4) is expressed in renal proximal tubule cells and released in response to hypoxia caused by decreased peritubular capillary blood flow, so serum FABP 4 is one of the promising biomarkers for early prediction of diabetic nephropathy in patients with type 2 diabetes.MethodsThis was a case–control study that included 120 patients with type-2 diabetes mellitus selected from Kasr Alainy Hospital, Cairo University Hospital, who were divided into 2 groups: the first group comprised 60 diabetic patients divided into 3 sub-groups according to their urinary albumin/creatinine ratio (normo-, micro-, and macroalbuminuria). The second group included 60 apparently healthy individuals. All patients were subjected to history, clinical examination, laboratory investigations, and serum FABP4 by ELISA.ResultsThere was a significant increase in serum FABP4 in the macroalbuminuria group, followed by the microalbuminuria group, then the normoalbuminuria group, in comparison to the normal control group. There was a significant positive correlation between serum FABP 4 level and the duration of diabetes and HBA1c. There was a significantly negative correlation between serum FABP4 and serum albumin in the macroalbuminuria group. Receiver operating characteristic curve analysis found that serum FABP 4 discriminate micro- and macroalbuminuric patients with diabetes from controls with 96.6% and 98.3% diagnostic specificity and 100% diagnostic sensitivity respectively.ConclusionSerum FABP 4 can be used as a biomarker for the early detection of diabetic nephropathy.

Early detection methods of chronic diabetic nephropathy in diabetes mellitus patients in primary health services

Introduction: The prevalence of diabetic kidney disease increases along with the increase in the number of patients with diabetes mellitus. Early detection of diabetic nephropathy in DM patients is an essential step in preventing the incidence of diabetic kidney disease. The study aimed to obtain a method of early detection of diabetic kidney disease in DM patients in primary health care via identifying factors associated with decreased glomerular filtration rate (GFR). Methods: We conducted a case-controlled study at the public health center in Bantul. The research subjects were patients at Kasihan 1 public health center aged 18-75 years. In-depth interviews will be conducted to obtain clinical and social risk factors for GFR decreasing as an early detection tool for diabetic nephropathy (DN) incidence. The IGF-1 levels were checked using ELISA. The Pearson correlation test observed a significant association between patient risk factors and GFR. Results: This study is expected to obtain a model of the method of early detection of chronic diabetic kidney disease in diabetes mellitus patients in primary health services. The results showed that the GFR was related to systolic blood pressure, diastolic blood pressure, hyperglycemia, nicotine levels, and IGF-1 levels (P&lt;0.00). Increased nicotine levels, increased blood pressure, hyperglycemia, and decreased levels of IGF-1 are associated with decreased GFR. Identifying factors related to the glomerular filtration rate can be used to predict impaired renal function. Conclusion: Reduced glomerular filtration rates are linked to higher nicotine levels, higher blood pressure, hyperglycemia, and lower IGF-1 levels.

Proteomic Biomarkers as Early Detection of Diabetic Nephropathy

Proteomic Biomarkers as Early Detection of Diabetic Nephropathy

The usefulness of serum beta-2 microglobulin as a biomarker for evaluating renal function decline in type II diabetes mellitus

Background and objective: Serum beta-2 microglobulin (β2M) has been used as a useful clinical marker of chronic kidney dysfunction. The current study aims to evaluate the diagnostic accuracy of β2M for the early detection of diabetic nephropathy among Iraqi patients with type II diabetes mellitus. Methods: The study included 84 participants divided into four groups, three of them were type II diabetics and the fourth is the healthy individuals’ (control) group. The diabetic’ subgroups were named according to the Micral test as: normoalbuminuria (21 patients), microalbuminuria (21 patients), and macroalbuminuria group (21 patients). The control group included 21, age- and sex-matched, healthy participants. Biochemical markers for diabetes mellitus as well as β2M were determined for each participant and then were analyzed statistically. Results: The serum β2M of normoalbuminuria group was (2.86±0.95 µg/mL), microalbuminuria group was (5.06±1.97 µg/mL) and macroalbuminuria group (3.6±1.59 µg/mL). The results showed significant increase (p˂0.05) in the β2M level of microalbuminuria group when compared with that of normoalbuminuria and macroalbuminuria groups. In addition, a highly significant increase (p˂0.01) in β2M concentration was observed in microalbuminuria group when compared with that of the control group. Conclusions: β2M can be used as a useful biomarker for the early detection of diabetic nephropathy.

Assessment of Relation of Serum Uric Acid &amp; Micro Albuminuria in the Patients of Diabetes Mellitus Type-2 for Early Detection of Diabetic Nephropathy

Background: Diabetic Nephropathy is one of the serious and life perilous complications of diabetes mellitus. Prolong duration of diabetes, no proper care and management, poor glycemic control in diabetic nephropathy can lead to End Stage Renal Disease (ESRD).&#x0D; Objective: To assess the relation of serum uric acid &amp; micro albuminuria in the patients of diabetes mellitus for early detection of diabetic nephropathy.&#x0D; Methodology: This cross-sectional study was conducted in the Department of Medicine, LUMHS Jamshoro, with a total of 80 diabetic patients as case study subjects and 80 non-diabetic healthy participants as controls. Random glucose was measured using the gluco oxidase technique, and serum uric acid was measured using the uricase enzyme method in a calorimeter. Immunoterbidimetory kit technique was used to calculate microalbuminuria.&#x0D; Results: The mean value of random blood sugar (RBS) in the control group was 135 ± 10.11 mg/dl, but RBS in the case study group was 224 ± 13.52 mg/dl, indicating that RBS in the case study group was extremely significant (P &lt; 0.001). The mean serum uric acid level in the control group was 4.7 ± 0.6 mg/dl, while it was 6.6 ± 1.4 mg/dl in the case study group, which is highly significant (P &lt;0.001) with correlation (r= 0.34). Albumin in urine in the control group was 10 .2 ± 1.78 mg/gm, while it was 54± 10.34mg/gm in the case study group, which is a significant (P&lt; 0.05) increase in the case study group with correlation (r= 0.28). In diabetics, serum uric acid and microalbuminuria show a positive connection.&#x0D; Conclusion: This study concluded that there is strong positive relation of serum uric acid and micro albuminuria in diabetic patients for the early detection of diabetic nephropathy.

A study on evaluating blood urea and serum creatinine in diabetes mellitus patients

Diabetes is one of the leading causes for end stage renal disease and nephropathy. Increases of blood urea and serum creatinine are due to abnormal renal function and also reduction in glomerular filtration rate. So, Urea and Creatinine are the ideal biomarkers to correlate the progression of diabetic nephropathy. Aim of the study is to evaluate the blood urea &amp; serum creatinine with HbA1C in Diabetes mellitus patients.: A total of 50 cases and 30 controls were selected in our study. Blood samples were collected for blood urea, serum creatinine, HbA1C, Fasting plasma glucose and Post prandial blood sugar with age limit of 35-65 years. Mean ±SD was calculated for all these parameters. Blood urea and Serum creatinine are statistically significant in Diabetic patients when compared to the controls.Our study shows that blood urea and serum creatinine can be used as biomarkers in the early detection of diabetic nephropathy. These parameters help in reducing the severity of renal failure.

Serum Amyloid A3 Promoter-Driven Luciferase Activity Enables Visualization of Diabetic Kidney Disease.

The early detection of diabetic nephropathy (DN) in mice is necessary for the development of drugs and functional foods. The purpose of this study was to identify genes that are significantly upregulated in the early stage of DN progression and develop a novel model to non-invasively monitor disease progression within living animals using in vivo imaging technology. Streptozotocin (STZ) treatment has been widely used as a DN model; however, it also exhibits direct cytotoxicity to the kidneys. As it is important to distinguish between DN-related and STZ-induced nephropathy, in this study, we compared renal responses induced by the diabetic milieu with two types of STZ models: multiple low-dose STZ injections with a high-fat diet and two moderate-dose STZ injections to induce DN. We found 221 genes whose expression was significantly altered during DN development in both models and identified serum amyloid A3 (Saa3) as a candidate gene. Next, we applied the Saa3 promoter-driven luciferase reporter (Saa3-promoter luc mice) to these two STZ models and performed in vivo bioluminescent imaging to monitor the progression of renal pathology. In this study, to further exclude the possibility that the in vivo bioluminescence signal is related to renal cytotoxicity by STZ treatment, we injected insulin into Saa3-promoter luc mice and showed that insulin treatment could downregulate renal inflammatory responses with a decreased signal intensity of in vivo bioluminescence imaging. These results strongly suggest that Saa3 promoter activity is a potent non-invasive indicator that can be used to monitor DN progression and explore therapeutic agents and functional foods.

Early detection of diabetic nephropathy in patient with type 2 diabetes mellitus: A review of the literature.

Type 2 diabetes mellitus is a pathology of heterogeneous etiology characterized by hyperglycemia resulting from lack of insulin action, insulin secretion, or both, and the population with diabetes mellitus is predicted to be about 439 million worldwide by 2030. Prolong diabetes has been related with microvascular complications especially diabetic nephropathy. DN is the most common complication of type 2 diabetes mellitus, and it is the leading cause of end-stage renal disease worldwide. It is crucial to diagnose patients who are more sensible to develop DN for better control of the process of disease. Several factors and mechanisms contribute to the development and outcome of diabetic nephropathy. Microalbuminuria is an early marker of DN and use it as a routine for screening, but the renal damages may be happening even without microalbuminuria. There are several significant kidney damage and disease biomarkers which helps in early detection of DN. An early biomarker may allow earlier diagnosis, treatment reduces DN prevalence and slows DN progression. Therefore, this review focuses on laboratory biomarkers that are earlier, more validation of an early and specific biomarker could potentially make it possible for early diagnosis, treatment, and retardation of progression of diabetic nephropathy.

Midkine: Utility as a Predictor of Early Diabetic Nephropathy in Children with Type 1 Diabetes Mellitus

Objective:This study aimed to assess the role of serum midkine (MK) as a biomarker for early detection of diabetic nephropathy in children with type 1 diabetes mellitus (T1DM) before microalbuminuria emerges.Methods:A total of 120 children with T1DM, comprising 60 microalbuminuric patients (Group 1), 60 normoalbuminuric patients (Group 2), and 60 healthy participants as a control group (Group 3) were included. Detailed medical history, clinical examination, and laboratory assessment of high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c percentage (HbA1c%), lipid profile, urinary albumin to creatinine ratio (ACR), serum MK and estimated glomerular filtration rate based on serum creatinine were performed in all participants.Results:Both Group 1 and Group 2 had significantly higher serum MK compared to controls (p<0.001). Additionally, significantly higher MK concentrations were present in Group 1 compared with Group 2 (p<0.001). Receiver operating characteristic curve analysis revealed that the MK concentration cutoff value of 1512 pg/mL was able to predict microalbuminuria with a sensitivity of 96% and specificity of 92%. Stepwise regression analysis revealed that HbA1c%, hs-CRP, and ACR were independently related to MK levels (p<0.001 for each).Conclusion:The results of this study suggest that serum MK is a useful, novel, practical marker for the evaluation of renal involvement in children with T1DM, especially in normoalbuminuric children.

Effect of Glycosylated Hemoglobin with Microalbuminuria and Albumin Creatinine Ratio in Type 2 Diabetes

Background: Diabetes mellitus has strong correlation with end stage renal disease (ESRD) and responsible for 30-40% of all ESRD cases.This study is focused on assessing the diabetic nephropathy status in patients with type 2 diabetes. Glycated hemoglobin levels over therapeutic targets (&gt;7%) had two times the risk of complications for diabetic nephropathy, ISN recommends the use of microalbuminuria and urinary albumin creatinine ratio (UACR) for early detection of diabetic nephropathy and for monitoring therapy. Objective: This study was conducted to prove the correlation between Glycated Albumin with microalbuminuria and UACR in type 2 diabetes. Methods: Cross sectional study was done in70diabetic type 2 patients who attended PROLANIS program in Primary Health Care from May to November 2018.Detailed medical history including the diabetes duration and relevant clinical examination like FBS, PPBS, HbA1c, urinary creatinineand urinary microalbumin were recorded in each patient.Significance is assessed at 5% level of significance. Results: This study obtained the mean age of the study population was 51.89 ± 6.78 years with female preponderance (51.1%).Mean FBS, PPBS, HbA1c, duration of diabetes, blood pressure, microalbuminuria and urinary creatinine were182.51 ± 74.63 mg/dL, 186.25±26.72 mg/dL, 8.8 ± 1.83%, 9.37±5.96 years, 138.44±14, 13/84.44±19.25 mmHg,30.32±3.2 mg/day and 1.33±0.64 mg/dl respectively.Microalbuminuria (r=0.91, p≤0.05) and UACR (r=0.67, p≤0.05) were positively associated with glycated hemoglobin. Conclusion: It can be concluded that microalbuminuria level and ACR increase in line with the worsening of glycosylated hemoglobin and diabetes duration. Keywords: Albumin Creatinine Ratio; Diabetes; HbA1c; Microalbuminuria

Evidence of Early Diabetic Nephropathy in Pediatric Type 1 Diabetes.

BackgroundDiabetic nephropathy (DN) is one of the most common microvascular complications in type 1 diabetes Mellitus (T1D). Urinary markers of renal damage or oxidative stress may signal early stages of DN. The association of these markers with blood pressure (BP) patterns and glycemic variability (GV) in children is yet to be explored.MethodsSubjects between the ages of 10 and 21 years with T1D were enrolled. Continuous glucose monitoring (CGM) and ambulatory blood pressure monitoring (ABPM) were performed on each subject. Urine samples were collected and analyzed for albumin, creatinine, neutrophil gelatinase-associated lipocalin (NGAL) and pentosidine.ResultsThe study included 21 subjects (62% female) with median age of 16.8 (IQR: 14.5, 18.9). Median HbA1C was 8.4 (IQR: 7.5, 9.3). While microalbuminuria was negative in all but one case (4.8%), urinary NGAL/Cr and pentosidine/Cr ratios were significantly elevated (P<0.001) in diabetic patients despite having normal microalbuminuria, and they correlated significantly with level of microalbumin/Cr (r=0.56 [CI: 0.17, 0.8] and r=0.79 [CI: 0.54, 0.91], respectively). Using ABPM, none had hypertension, however, poor nocturnal systolic BP dipping was found in 48% of cases (95% CI: 28-68%). Urinary NGAL/Cr negatively correlated with nocturnal SBP dipping (r=-0.47, CI: -0.76, -0.03). Urine NGAL/Cr also showed a significant negative correlation with HbA1c measurements, mean blood glucose, and high blood glucose index (r=-0.51 [CI: -0.78, -0.09], r=-0.45 [CI: -0.74, -0.03], and r=-0.51 [CI: -0.77, -0.1], respectively). Median urinary NGAL/Cr and pentosidine/Cr ratios were higher in the high GV group but were not significantly different.DiscussionThis pilot study explores the role of ABPM and urinary markers of tubular health and oxidative stress in early detection of diabetic nephropathy. GV may play a role in the process of this diabetic complication.

Identification of Novel Biomarker for Early Detection of Diabetic Nephropathy.

Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus. After development of DN, patients will progress to end-stage renal disease, which is associated with high morbidity and mortality. Here, we developed early-stage diagnostic biomarkers to detect DN as a strategy for DN intervention. For the DN model, Zucker diabetic fatty rats were used for DN phenotyping. The results revealed that DN rats showed significantly increased blood glucose, blood urea nitrogen (BUN), and serum creatinine levels, accompanied by severe kidney injury, fibrosis and microstructural changes. In addition, DN rats showed significantly increased urinary excretion of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL). Transcriptome analysis revealed that new DN biomarkers, such as complementary component 4b (C4b), complementary factor D (CFD), C-X-C motif chemokine receptor 6 (CXCR6), and leukemia inhibitory factor (LIF) were identified. Furthermore, they were found in the urine of patients with DN. Since these biomarkers were detected in the urine and kidney of DN rats and urine of diabetic patients, the selected markers could be used as early diagnosis biomarkers for chronic diabetic nephropathy.

Diagnostic efficacy of serum and urinary netrin-1 in the early detection of diabetic nephropathy

This study aimed to assess the diagnostic value of serum and urinary netrin-1 in patients with type 2 diabetes mellitus (T2DM) at different stages of diabetic nephropathy (DN) and to...

Study of serum adiponectin levels for early detection of type 2 diabetes mellitus and its complications on kidney

Background: Type 2 diabetes mellitus is a chronic metabolic disorder due to insulin resistance caused by destruction of beta cells of pancreas. Insulin resistance in newly diagnosed type 2 diabetes mellitus patients leads to hyperglycemia. Serum adiponectin is a more sensitive and specific biomarker for early detection of diabetic nephropathy than urinary microalbuminuria.Methods: This is a case-control study conducted in Akash Institute of Medical Sciences, A total 180 subjects (120 cases and 60 controls). All the subjects included after informed consent, blood samples and urine samples are collected from the all the subjects. The serum Adiponectin and was estimated by using enzyme-linked immunoassay (ELISA) and fasting blood sugar (FBS), post prandial blood sugar (PPBS) and renal function test (RFT) was also estimated by laboratory standard methods.Results: This study was evaluated the FBS, PPBS, RFT and serum adiponectin levels in patients with type 2 diabetes mellitus patients and compare them with healthy controls. The serum adiponectin levels more significantly elevated in newly diagnosed type 2 diabetes mellitus patients and compared with the healthy controls. The study also found that significantly elevated levels of FBS, PPBS and RFT in type 2 diabetes mellitus patients and compared with the healthy controls, The statistically significant levels of serum adiponectin in patients with type 2 diabetes mellitus and when compared with the controls (p= 0.0001).Conclusions: The study suggesting that the s estimation of serum adiponectin levels in newly diagnosed type 2 diabetes mellitus patients useful for early detection of diabetic nephropathy. Because elevated levels of serum adiponectin in patients with newly diagnosed type 2 diabetes mellitus, this levels are positively correlated with the FBS and PPBS.

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

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.