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2017 ; 16
(3
): 101-106
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Evaluation of neutrophil gelatinase-associated lipocalin and cystatin C as early
markers of diabetic nephropathy
#MMPMID28671149
Siddiqi Z
; Karoli R
; Kaul A
; Fatima J
; Varshney S
; Beg MS
Ann Afr Med
2017[Jul]; 16
(3
): 101-106
PMID28671149
show ga
INTRODUCTION: Diabetes mellitus (DM) is a major cause of concern because of its
increasing prevalence rate and related microvascular as well as macrovascular
complications, including kidney disease. Microalbuminuria has been accepted as
the earliest marker for diabetic nephropathy; however, a large proportion of
renal impairment occurs in nonalbuminuric state. We planned to investigate the
serum and urinary levels of the tubular damage markers (neutrophil
gelatinase-associated lipocalin [NGAL] and cystatin C [Cys C]) in patients of
type 2 diabetes to detect early kidney injury. MATERIALS AND METHODS: This
cross-sectional hospital-based study included 180 patients with type 2 DM
according to the American Diabetes Association criteria. Serum NGAL (S.NGAL) and
urine NGAL (U.NGAL) and Cys C were measured in all study participants and
investigated for correlation with microalbuminuria. RESULTS: Our results showed
that U.NGAL and S.NGAL levels were significantly high in patients with
microalbuminuria as compared to normoalbuminuric controls. Serum Cys C was also
higher in microalbuminuric patients than who had normoalbuminuria. A positive
correlation of urinary albumin excretion with S.NGAL and U.NGAL was noted. U.NGAL
also showed positive correlation with duration of diabetes, glycated hemoglobin,
and dyslipidemia. Receiver operating characteristic curve analysis showed that
the area under the curve for U.NGAL and S.NGAL were 1 and 0.8, respectively,
which indicates that they are sensitive markers for early renal damage.
CONCLUSION: Urinary biomarkers were significantly elevated in normoalbuminuric
type 2 diabetic patients compared with nondiabetic controls and could be used as
markers of nephropathy at a very early stage even before the development of
microalbuminuria, the current gold standard for early diagnosis. Despite the
promise of these new biomarkers, further large, multicenter prospective studies
are still needed.
|Albuminuria/*urine
[MESH]
|Biomarkers/blood/urine
[MESH]
|Cross-Sectional Studies
[MESH]
|Cystatin C/*blood/urine
[MESH]
|Diabetes Mellitus, Type 2/blood/*complications/physiopathology
[MESH]