Early Diagnosis Of Diabetic Nephropathy Research Articles

Role of Beta Trace Protein and Cystatin C as a Potential Biomarker for Early Detection of Type 2 Diabetic Nephropathy

Background: One of the most well-known diabetic microvascular consequences is diabetic nephropathy, which affects 40 percent of people with diabetes mellitus type 2. It develops into end stage renal disease, and diabetes biomarkers can be used as a predictor. Objectives: This study aimed to determine the concentration levels of serum Beta Trace Protein and serum Cystatin C in all stages of diabetic nephropathy disease. Subjects And Methods: A Case- control study included 120 Persons (30-persons appeared healthy as control and 90 patients proved with T2DM of both gender (64 males and 56 females), split into four groups by using urinary micro-albumin and albumin to creatinine ratio (UACR) as following: group-I: includes 30persons as a healthy control (UACR < 30 mg/g creatinine). Group-II: includes 30patients with type2 DM normoalbuminuria (UACR < 30 mg/g creatinine) as a positive control. Group-III: includes 30 patients with type 2 DM microalbuminuria (UACR 30 – 300 mg/g creatinine). Group-IV: includes 30 patientsا with type 2 DM macroalbuminuria (UACR˃ 300 mg/g creatinine), all groups with ages ranges between (40-69) years. in allا groups, Beta Trace Protein and Cystatin C quantitative enzyme immunoassay (double-antibody sandwich), calculated in serum and both biomarkers using the same methods. Results: Patients with diabetes have statistically substantially increased blood levels of Beta trace protein and Cystatin C. with macro-albuminuria groups in comparison to micro-albuminuria, normo-albuminuria and healthy control in addition, the mean for the micro-albuminuria group was greater than for the healthy control and normo-albuminuria groups. Conclusion: A rise in blood Beta trace protein and Cystatin C levels in the early nephropathy group microalbuminuria, which may be used as a predictor for early diagnosis of diabetic nephropathy.

A meta-analysis of urinary transferrin for early diagnosis of diabetic nephropathy

Abstract Objective To assess the diagnostic value of urinary transferrin (Tf) in early diabetic nephropathy (DN) to propose a more sensitive and noninvasive biomarker for screening and monitoring DN in clinical practice. Methods We searched 3 databases from their inception to May 2023, to identify studies investigating the diagnostic value of Tf in patients with DN. Meta-DiSc software, version 1.4, and Stata software, version 15.1 (StataCorp) were used to conduct a meta-analysis and evaluate the diagnostic accuracy of urine Tf levels for DN. Results The meta-analysis included 6 relevant studies investigating the diagnostic value of Tf level for DN. Urinary Tf as a diagnostic marker demonstrated a combined sensitivity of 0.82 (95% CI, 0.71-0.89) and specificity of 0.88 (0.84-0.92). the positive diagnostic likelihood ratio was 7.07 (4.57-10.93), the negative diagnostic likelihood ratio was 0.20 (0.12-0.35), and the diagnostic odds ratio was 34.49 (13.61-87.44). Also, the area under the receiver operating characteristic curve was 0.92 (0.89-0.94), indicating that urinary Tf has a decent discriminative ability in diagnosing DN. Conclusion Tf level is a valuable biological marker for early diagnosis and monitoring of DN in clinical practice. It has statistically significant predictive value for patients in the early phases of DN.

Study of Neutrophil Gelatinase Associated Lipocalin and Kidney Injury Molecule-1 in Patients with Type 2 Diabetes Mellitus Nephropathy.

There is a need for accurate and rapid biomarkers for the early diagnosis of diabetic nephropathy (DN). We aimed to study the accuracy of urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary kidney injury molecule-1 (uKIM-1), and blood NGAL (bNGAL) in type 2 diabetics as biomarkers for diagnosis of DN. The study was a retrospective case-control study that included 30 control subjects, 40 diabetics with normo-albuminuria < 30 mg/g and eGFR > 60 mL/minute/1.73 m2, and 30 diabetics with albuminuria > 30mg/g and eGFR < 60mL/minute/1.73 m2. Blood and urine samples were obtained to determine levels of bNGAL, uNAGAL, and uKIM1. There was a significant increase in bNGAL, uNGAL, uKIM 1, uNGAL/creatinine and uKIM 1/creatinine among diabetics with albuminuria compared to diabetics with normoalbuminuria and normal control (p < 0.001 for all markers). For diagnosis of early DN, both bNGAL and uKIM 1 had sensitivity and specificity of 100% for each at cutoff values of 322.5 pg/mL and 74.25 ng/mL, respectively. uNGAL had a sensitivity of 97.5% and a spec-ificity of 100% at a cutoff point of 565 ng/mL. uKIM1/creatinine at a cutoff of 51.2 had a sensitivity of 100% and specificity of 100%. The present study highlights the accuracy of urinary KIM1 and NGAL and blood NGAL as biomarkers for the diagnosis of nephropathy in the early stage of diabetic nephropathy. There were positive correlations with kidney function tests creatinine, blood urea nitrogen, and the presence of albuminuria.

Engineering a highly selective leucine aminopeptidase near-infrared fluorescence probe for early diagnosis of diabetic nephropathy

Diabetic nephropathy (DN) is one of the most serious and general complications of diabetes, while schedules for prevention and treatment are unsatisfactory. Leucine aminopeptidase (LAP) as one of the biomarkers of DN is associated with glomerular and/or tubular injury. Imaging of LAP activity in DN disease model in vivo is thus beneficial for early diagnosis and prevention of DN, but such a strategy is still lacking. Herein, an enzyme-activated probe HD-LAP with a NIR fluorescence emission for specific detection of LAP activity in the DN model is designed and synthesized. HD-LAP has a significant fluorescence enhancement after reacted with LAP and shows a NIR fluorescence emission at 704 nm based on intramolecular charge transfer mechanism. Moreover, HD-LAP can be employed to image LAP activity in HK-2 and HepG2 cells. More importantly, HD-LAP is the first example to real-time image LAP in DN mice and clinical serum samples. These results demonstrated that HD-LAP is promising as a powerful tool for the research on LAP associated diabetic diseases in future.

Performance of Urinary Clusterin as a Biomarker for Diagnosis of Early Diabetic Nephropathy in type 2 Diabetes

Performance of Urinary Clusterin as a Biomarker for Diagnosis of Early Diabetic Nephropathy in type 2 Diabetes

A Cross-Sectional Study on the Estimation of Urine Albumin for the Early Diagnosis of Diabetic Nephropathy Among Patients With Diabetes Mellitus at a Tertiary Care Hospital in Central India.

Background Diabetic nephropathy is a significant concern among individuals with diabetes mellitus, warranting early diagnosis for effective management. This study focuses on the potential of urine albumin estimation as an early diagnostic tool for diabetic nephropathy among patients in central India. Methods A cross-sectional methodology involved 65 individuals diagnosed with diabetes mellitus at a tertiary care hospital. Demographic factors, including age, gender, family history, duration of diabetes, and dietary patterns, were gathered. Urine albumin levels were categorized as "normal," "microalbuminuria," and "macroalbuminuria." The collected data were analyzed using IBM SPSS Statistics, version 24.0 (IBM Corp., Armonk, NY). Qualitative variables were presented as percentages and counts. The comparison between groups was conducted using the chi-square exact test. Quantitative variables were described as mean (±standard deviation) and median. Results The study reveals that 78.5% of cases exhibited normal levels below 30 mg, with a mean value of 1.00 ± 0.414. Microalbuminuria, characterized by 30-300 mg levels, was observed in 21.5% of cases. Importantly, no instances of macroalbuminuria, with levels exceeding 300 mg, were detected among the participants.There are associations between demographic variables and diabetic nephropathy findings. Age and gender displayed non-significant associations. Family history of diseases, particularly diabetes, showed significance. Diabetes duration demonstrated a significant link, while diet patterns displayed no significant associations. Conclusion This study contributes insights into the complex interactions of demographic factors in diabetic nephropathy. Early identification and intervention, guided by the associations observed, could enhance patient outcomes and mitigate the burden of diabetic nephropathy-related complications. Further research is warranted to validate and extend these findings to diverse populations.

Cobalt oxide modified sulfur and phosphorus Co-doped g-C3N4 for screening of urinary human albumin.

Thefabrication of a heteroatom-doped nanocomposite based on cobalt oxide modified sulfur, phosphorus co-doped carbon nitride (Co3O4/SP-CN) with increased active sitesis reported. The synthesized nanocomposite offers surprisingly high electrocatalytic oxidation efficacy toward human albumin (HA) despite its agglomeration. This improved efficacy of Co3O4/SP-CN nanocomposite could be attributed to its increased adsorption sites and surface defects, fast charge transportation capability, and conductivity. Additionally, morphological and compositional analysis of the fabricated Co3O4/SP-CN material has been performed through scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray photon spectroscopy (XPS), and Raman spectroscopy. The fabricated electrode shows remarkable amperometric response against the HA witha limit of detection of 8.39 nM and linear rangeof 20-4000 nM at applied potential of 0.25 V versus Ag/AgCl in 0.1 M PBS (pH 8.2). The designed Co3O4/SP-CN electrode has been successfully applied to monitor HA in urine samples of diabetic patient with recovery percentage from 94.1 and 92.1% and with relative standard deviation (RSD) values of 5.8 and 7.8%. According to the best of our knowledge, this is the first report to use aCo3O4/SP-CN-based graphitic pencil (GP) electrode for monitoring of HA for early diagnosis of diabetic nephropathy.

Correlation of Serum Chromogranin A with HbA1c and eGFR in Different Groups of Type 2 Diabetic patients

Background: World health organization estimated that around 422 million people are living with diabetes and there is an increasing trend in the number of diabetic patients. Aim: To correlate the levels of serum chromogranin A with HbA1c and eGFR in different groups of type 2 diabetic patients based on urinary Albumin- Creatinine Ratio. Methodology: This cross sectional comparative study was done by enrolling 116 patients at Chemical Pathology Department, LGH-Lahore through probability convenient sampling. Urine samples of all subjects were centrifuged in-order to measure urinary albumin and creatinine. Laboratory parameters like Urinary albumin, Serum creatinine and HbA1c were measured. HbA1c was measured using HPLC method. Serum creatinine was measured kits on fully automated spectrophotometer. Abbreviated MDRD equation calculated eGFR. Data SPSS v.24 analyzed the data. ANOVA test applied with P-value of less than 0.05 was considered significant. Spearman correlation was also applied to correlate HbA1c and eGFR with CgA in each group. Results: The results showed that eGFR was normally distributed whereas, the distribution of albumin creatinine ratio, HbA1c, serum creatinine and serum chromogranin-A were not normal. Between the A, B, and C groups, no discernible variation in the mean HbA1c values was found. Practical Implication: Due to lack of literature review and high incidence of diabetes induced nephropathy in our setups, there is need to find a parameter than can correlate nephropathy among diabetics. Conclusion: It was concluded that early diagnosis of diabetic nephro-pathy can be evaluated by using serum Chromogranin-A but it has a negative correlation with eGFR and positive correlation with HbA1c. Keywords: Diabetic Nephropathy, HbA1c, Estimated Glomerular Filtration Rate, Serum Chromogranin-A and Type-2 Diabetes.

Evaluation of Some Immunological Parameters in with Men Diabetic Nephropathy

The Aim: The study aims to the possibility of depending on some immunological criteria (monocyte chemoattractant protein (MCP-1, MCP-3) and interleukin-18).&#x0D; Study Design: The study is indicators for early diagnosis of diabetic nephropathy in patients with type 2 diabetes and avoiding its development to advanced stages.&#x0D; Place and Duration of Study: Endocrinology Center / Al-Sadr Medical City and also Al-Manathira General Hospital / Al-Najaf Governorate, their ages ranged between (30- 60) years old, and the study continued for the period from 1/10/2022 to 31/3/2023 after obtaining the consent of the two study groups.&#x0D; Methodology: The study included the follow-up of (90) men, (30) healthy individuals and (60) patients with type 2 diabetes mellitus to periodic clinical examination ,the estimation of glycosylated hemoglobin ratio (HbA1c) and evaluation of immunological parameters represented in levels of monocyte chemoattractant protein (MCP-1 , MCP-3 ) and interleukin-18 .&#x0D; Results: The study diagnosed a significant increase (P &lt; 0.05) in glycosylated hemoglobin ratio, monocyte chemoattractant protein MCP-1, MCP-3) and interleukin-18 ,and in contrast to a significant decrease (P &lt; 0.05) in the glomerular filtration rate (GFR) in men with diabetes mellitus type II compared to healthy men.&#x0D; The study also showed a significant effect (P &lt; 0.05) for the age groups on the glycosylated hemoglobin ratio and monocyte chemoattractant protein (MCP-3), and conversely a significant decline in the glomerular filtration rate (GFR) ,while no significant differences appeared (P &gt; 0.05) in levels of monocyte chemoattractant protein (MCP-1) and interleukin-18. Also, a notable impact (P &lt; 0.05) was observed for the duration of diabetes mellitus on the levels of monocyte chemoattractant protein (MCP-1 , MCP-3 ),whereas no substantial differences appeared (P &gt; 0.05) in levels of glycosylated hemoglobin ratio, glomerular filtration rate (GFR) and interleukin-18.&#x0D; In addition to the foregoing, the trial recorded a significant influence (P &lt; 0.05) of body mass index on the levels of monocyte chemoattractant protein (MCP-3),while no noticeable differences appeared (P &gt; 0.05)in, the glycosylated hemoglobin ratio , glomerular filtration rate(GFR),and monocyte chemoattractant protein (MCP-1).&#x0D; Moreover, a significant effect (P &lt; 0.05) for stages of diabetic nephropathy was diagnosed on the glycosylated hemoglobin ratio, monocyte chemoattractant protein (MCP-1, MCP-3), interleukin-18 and glomerular filtration rate (GFR).&#x0D; Conclusion: It is possible to depend on the increased levels of some immunological indicators especially MCP-1, MCP-3 and interleukin-18 as predictive biomarkers to diagnose the progression to advance stages of the diabetic nephropathy if this coincides with a decrease in the glomerular filtration rate.

Osteoinductive factor as a significant marker for the diagnosis of early diabetic nephropathy

Osteoinductive factor as a significant marker for the diagnosis of early diabetic nephropathy

Changes of Serum Bone Metabolism Indexes and Ultrasonic Bone Mineral Density in Patients with Diabetic Nephropathy at Different Stages and their effects on Diabetic Renal Microvascular Complications.

To determine the changes in serum bone metabolism indexes and ultrasonic bone mineral density (BMD) in patients with diabetic nephropathy at different stages, and their effects on diabetic renal microvascular complications. This is a clinical comparative study. One hundred twenty two diabetic patients admitted to the Baoding No.1 Central Hospital from January 2020 to March 2022 were selected as subjects and divided into three groups according to their actual condition: the simple diabetes (Group-A, 40 cases), diabetic nephropathy with micro urinary protein (Group-B, 40 cases) and diabetic nephropathy with massive proteinuria (Group-C, 42 cases). Another 36 healthy subjects were selected as the control group. Differences in serum bone metabolism indexes and ultrasound BMD levels were compared. Twenty five hydroxy-vitamin D, BGP, T-PINP and ultrasound BMD levels in the control group were > Group-A > Group-B > Group-C, PTH and β-CTX in the control group were < Group-A < Group-B < Group-C, statistically significant differences (p<0.05). The urinary albumin to urinary creatinine ratio (ACR) value in Group-B was significantly lower than Group-C (p<0.05). Logistic regression analysis showed that 25-hydroxy-vitamin D, PTH, BGP, β-CTX, T-PINP and ultrasound BMD were the influencing factors of diabetic renal microvascular complications (p<0.05). Bone metabolism indexes and ultrasound bone mineral density are abnormally expressed in patients with diabetic nephropathy at different stages, which are closely related to the urine protein of patients. They have important clinical value in the diagnosis of early diabetic nephropathy.

Assesment of serum taurine level as a potential biomarker for early diagnosis of diabetic nephropathy

Assesment of serum taurine level as a potential biomarker for early diagnosis of diabetic nephropathy

Assesment of serum taurine level as a potential biomarker for early diagnosis of diabetic nephropathy

Objective: Measuring of serum taurine as an early marker to detect and prevent complications of Diabetic nephropathy. Method: Ninty diabetic patients (male and female) were chosen from Ahmed Maher hospital after their approval, eighty patients classified into four groups (diabetic control group, early stage group, before dialysis group, after dialysis group) according to its Complete clinical examination, investigation and biochemical analysis, twenty diabetic controlled patients not suffered from kidney impairment considered as diabetic control group. ten frank healthy non diabetic persons enrolled as volunteers. Complete clinical examination, investigation and biochemical analysis (liver and kidney functions, lipid profile), add to measuring Blood sugar, HbA1c, and the recent biomarker taurine, was measured for all patient and volunteers. Results: The data showed non-significant change in lipid profile, creatinine in urine, and serum Albumine in all patients regarding to control group (P&gt;0.05). that Liver function in all groups demonstrated non significance between groups,but values recorded significant changes in all groups of patients related to frank control group (p&lt;0.05). Kidney function (urea – creatinine) values recorded very highly significant changes in all groups of patients related to frank control group (p&lt;0.00), except controlled diabetic group and Early stage of diabetic nephropathy. also, there is a highly significant changes in blood glucose and HbA1c (P&gt;0.001). On the other hand, the data showed extremely significant decrease in serum taurine in all diabetic patients according to the severity of diabetic nephropathy compared to that recorded in healthy control (P&lt;0.000). Conclusion: Serum taurine is reduced in diabetic patients with advanced conditions of diabetic nephropathy. Taurine Level is considered as an early marker (prognostic) to detect and prevent the diabetic nephropathy complications.

Urinary heme oxygenase-1 as a possible marker for early diagnosis of diabetic nephropathy and retinopathy

Urinary heme oxygenase-1 as a possible marker for early diagnosis of diabetic nephropathy and retinopathy

Analysis and evaluation of correlation between DNA polymorphism in the genes MTHFR, PAI-1 and serum creatinine, creatinine clearance and albumin/creatinine ratio in morning urine of patients with type 2 diabetes mellitus and diabetic nephropathy.

Diabetic nephropathy is a major microangiopathic complication of type 2 diabetes and a leading cause of chronic kidney disease (CKD).

Transcriptome Analysis Identifies Oxidative Stress Injury Biomarkers for Diabetic Nephropathy

The early diagnosis of diabetic nephropathy (DN) is essential for improving the prognosis and effectively manage patients affected with this disease. The standard biomarkers, including albuminuria and glomerular filtration rate, are not very precise. New molecular biomarkers are needed to more accurately identify DN and better predict disease progression. Characteristic DN biomarkers can be identified using transcriptomic analysis. To evaluate the transcriptomic profile of controls (CTRLs, n=15), patients with prediabetes (PREDM, n=15), patients with type-2 diabetes mellitus (DM2, n=15), and patients with DN (n=15) by microarray analysis to find new biomarkers. RT-PCR was then used to confirm gene biomarkers specific for DN. Blood samples were used to isolate RNA for microarray expression analysis. 26,803 unique gene sequences and 30,606 LncRNA sequences were evaluated-Selected gene biomarkers for DN were validated using qPCR assays. Sensitivity, specificity, and area under the curve (AUC) were calculated as measures of diagnostic accuracy. The DN transcriptome was composed of 300 induced genes, compared to CTRLs, PREDM, and DM-2 groups. RT-qPCR assays validated that METLL22, PFKL, CCNB1 and CASP2 genes were induced in the DN group compared to CTRLs, PREDM, and DM-2 groups. The ROC analysis for these four genes showed 0.9719, 0.8853, 0.8533 and 0.7748 AUC values, respectively. Among induced genes in the DN group, we found that CASP2, PFKL and CCNB1 may potentially be used as biomarkers to diagnose DN. Of these, METLL22 had the highest AUC score, at 0.9719.

Early renal structural changes and potential biomarkers in diabetic nephropathy.

Diabetic nephropathy is one of the most serious microvascular complications of diabetes mellitus, with increasing prevalence and mortality. Currently, renal function is assessed clinically using albumin excretion rate and glomerular filtration rate. But before the appearance of micro-albumin, the glomerular structure has been severely damaged. Glomerular filtration rate based on serum creatinine is a certain underestimate of renal status. Early diagnosis of diabetic nephropathy has an important role in improving kidney function and delaying disease progression with drugs. There is an urgent need for biomarkers that can characterize the structural changes associated with the kidney. In this review, we focus on the early glomerular and tubular structural alterations, with a detailed description of the glomerular injury markers SMAD1 and Podocalyxin, and the tubular injury markers NGAL, Netrin-1, and L-FABP in the context of diabetic nephropathy. We have summarized the currently studied protein markers and performed bioprocess analysis. Also, a brief review of proteomic and scRNA-seq method in the search of diabetic nephropathy.

Two user-friendly models and a simple cutoff value of Neutrophil to Lymphocyte ratio (NLR) for early Diagnosis of Diabetic Nephropathy in middleelderly aged pa-tients with Type 2 Diabetes: A Cross-sectional study

Two user-friendly models and a simple cutoff value of Neutrophil to Lymphocyte ratio (NLR) for early Diagnosis of Diabetic Nephropathy in middleelderly aged pa-tients with Type 2 Diabetes: A Cross-sectional study

A New Method for Albuminuria Measurement Using a Specific Reaction between Albumin and the Luciferin of the Firefly Squid Watasenia scintillans.

This study demonstrates that the luciferin of the firefly squid Watasenia scintillans, which generally reacts with Watasenia luciferase, reacted with human albumin to emit light in proportion to the albumin concentration. The luminescence showed a peak wavelength at 540 nm and was eliminated by heat or protease treatment. We used urine samples collected from patients with diabetes to quantify urinary albumin concentration, which is essential for the early diagnosis of diabetic nephropathy. Consequently, we were able to measure urinary albumin concentrations by precipitating urinary proteins with acetone before the reaction with luciferin. A correlation was found with the result of the immunoturbidimetric method; however, the Watasenia luciferin method tended to produce lower albumin concentrations. This may be because the Watasenia luciferin reacts with only intact albumin. Therefore, the quantification method using Watasenia luciferin is a new principle of urinary albumin measurement that differs from already established methods such as immunoturbidimetry and high-performance liquid chromatography.

Clinical-diagnostic and genetic features of early diagnosis of diabetic nephropathy

Clinical-diagnostic and genetic features of early diagnosis of diabetic nephropathy