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CC BY-NC-ND 4.0 · J Lab Physicians 2022; 14(04): 497-504
DOI: 10.1055/s-0042-1757718
Original Article

Urinary Nephrin is a Sensitive Marker to Predict Early Onset of Nephropathy in Type 2 Diabetes Mellitus

Ganesh Veluri
1   Department of Biochemistry, Arupadai Veedu Medical College and Hospital, Vinayaka Missions Research Foundation (deemed to be university, Salem, Tamil Nadu), Kirumampakkam, Puducherry, India
,
Murugan Mannangatti
1   Department of Biochemistry, Arupadai Veedu Medical College and Hospital, Vinayaka Missions Research Foundation (deemed to be university, Salem, Tamil Nadu), Kirumampakkam, Puducherry, India
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Abstract

Objective The present study has been designed to evaluate urinary nephrin that best predicts the occurrence of renal dysfunction in type 2 diabetes mellitus patients and its correlation with clinical parameters of nephropathy.

Materials and Methods A total of 80 type 2 diabetes mellitus and 40 age- and gender-matched healthy controls were recruited. Biochemical and clinical parameters were analyzed in all the study participants. Analysis of variance was performed to compare the differences between the groups. Pearson's correlation analysis was used to analyze the association of nephrin with clinical parameters of nephropathy. Receiver operating characteristic curves were constructed to study the diagnostic accuracy of markers to identify diabetic nephropathy.

Results The levels of nephrin were significantly elevated in both groups of type 2 diabetes mellitus patients when compared with healthy individuals (p = 0.0001). The urinary nephrin was positively correlated with hemoglobin A1c and urinary albumin creatinine ratio (r = 0.520, 0.657, p < 0.0001) and negatively correlated with estimated glomerular filtration rate (r = –0.539, p < 0.0001). The diagnostic sensitivity and specificity of nephrin for nephropathy were 100 and 88%, respectively, and urinary albumin creatinine ratio was 43 and 76%, respectively.

Conclusion The study findings suggest that nephrin levels are strongly and positively associated with nephropathy in type 2 diabetes mellitus patients and it has a greater potential to be an early predictable marker of nephropathy than urinary albumin creatinine ratio.

Keywords

HbA1c - type 2 diabetes mellitus - urinary nephrin

Authors' Contributions

V.G. contributed to study design, selection of subjects, collection of samples, processing, data analysis, and writing manuscript. M.M. contributed to assisting in the study design, selection of subjects, collection of samples, processing, data analysis, and writing manuscript. V.K.G. contributed to assisting in the study design, selection of subjects, collection of samples, processing, data analysis, and writing manuscript.


Ethical Approval

The subcommittee constituted by institutional ethical committee, Basaveshwara Medical College and Hospital, Chitradurga, Karnataka, India has reviewed and discussed my protocol on 28/03/2019 to conduct the research project (Ref. BMC&H/IEC/2018–2019/07).




Publication History

Article published online:
26 October 2022

© 2022. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Badr A, Muhammad IU, Muhammad A. et al. Determination of serum adiponectin levels in type 2 diabetes patients of the Saudi population in the Al-Jouf region. Rom J Diabetes Nutr Metab Dis 2020; 3: 1-10
    Google Scholar
  • 2 Salam RS, Laikangbam S, Tina D. et al. Adiponectina and body mass index in type 2 diabetes mellitus. Int J Contemp Med Res 2020; 4: 1-4
    Google Scholar
  • 3 Raghuram N, Parul B, Akshay A. et al. Prevalence of diabetes and its determinants in the young adults Indian population-call for yoga intervention. Front Endocrinol 2020; 11: 1-9
    CrossrefPubMedGoogle Scholar
  • 4 Uwaezuoke SN. The role of novel biomarkers in predicting diabetic nephropathy: a review. Int J Nephrol Renovasc Dis 2017; 10: 221-231
    CrossrefPubMedGoogle Scholar
  • 5 Vlad A, Vlad M, Petrica L. et al. Therapy with atorvastatin versus rosuvastatin reduces urinary podocytes, podocyte-associated molecules, and proximal tubule dysfunction biomarkers in patients with type 2 diabetes mellitus: a pilot study. Ren Fail 2017; 39 (01) 112-119
    CrossrefPubMedGoogle Scholar
  • 6 Abdelbassit E, Maha Abdelmoneim B, Somia Abdelhameed B. et al. Urinary podocin level as a predictor of diabetic kidney disease. J Nephropathol 2019; 8 (03) 26
    Google Scholar
  • 7 Rigalleau V, Lasseur C, Raffaitin C. et al. Normoalbuminuric renal-insufficient diabetic patients: a lower-risk group. Diabetes Care 2007; 30 (08) 2034-2039
    CrossrefPubMedGoogle Scholar
  • 8 Popovic D, Lalic K, Jotic A. et al. The inflammatory and hemostatic cardiovascular risk marke during acute hyperglycemic crisis in type 1 and type 2 diabetes. J Med Biochem 2019; 38 (02) 126-133
    CrossrefPubMedGoogle Scholar
  • 9 Kostovska I, Tosheska-Trajkovska K, Topuzovska S. et al. Urinary nephrin is earlier, more sensitive and specific marker of diabetic nephropathy than microalbuminuria. J Med Biochem 2020; 39 (01) 83-90
    PubMedGoogle Scholar
  • 10 Pettersson-Fernholm K, Forsblom C, Perola M, Groop PH. FinnDiane Study Group. Polymorphisms in the nephrin gene and diabetic nephropathy in type 1 diabetic patients. Kidney Int 2003; 63 (04) 1205-1210
    CrossrefPubMedGoogle Scholar
  • 11 Jim B, Ghanta M, Qipo A. et al. Dysregulated nephrin in diabetic nephropathy of type 2 diabetes: a cross sectional study. PLoS One 2012; 7 (05) e36041
    CrossrefPubMedGoogle Scholar
  • 12 American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2017; 40 (01) S1-S135
    PubMedGoogle Scholar
  • 13 Saran R, Robinson B, Abbott KC. et al. US renal data system 2016 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 2017; 69 (3, Suppl 1): A7-A8
    CrossrefPubMedGoogle Scholar
  • 14 National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002; 39 (2, Suppl 1): S1-S266
    PubMedGoogle Scholar
  • 15 Drummond K, Mauer M. International Diabetic Nephropathy Study Group. The early natural history of nephropathy in type 1 diabetes: II. Early renal structural changes in type 1 diabetes. Diabetes 2002; 51 (05) 1580-1587
    CrossrefPubMedGoogle Scholar
  • 16 Ponchiardi C, Mauer M, Najafian B. Temporal profile of diabetic nephropathy pathologic changes. Curr Diab Rep 2013; 13 (04) 592-599
    CrossrefPubMedGoogle Scholar
  • 17 Tan AL, Forbes JM, Cooper ME. AGE, RAGE, and ROS in diabetic nephropathy. Semin Nephrol 2007; 27 (02) 130-143
    CrossrefPubMedGoogle Scholar
  • 18 Veron D, Bertuccio CA, Marlier A. et al. Podocyte vascular endothelial growth factor (Vegf164) overexpression causes severe nodular glomerulosclerosis in a mouse model of type 1 diabetes. Diabetologia 2011; 54 (05) 1227-1241
    CrossrefPubMedGoogle Scholar
  • 19 Kondapi K, Kumar NL, Moorthy S, Silambanan S. A study of association of urinary nephrin with albuminuria in patients with diabetic nephropathy. Indian J Nephrol 2021; 31 (02) 142-148
    CrossrefPubMedGoogle Scholar
  • 20 Gross JL, de Azevedo MJ, Silveiro SP, Canani LH, Caramori ML, Zelmanovitz T. Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care 2005; 28 (01) 164-176
    CrossrefPubMedGoogle Scholar
  • 21 Hong CY, Chia KS. Markers of diabetic nephropathy. J Diabetes Complications 1998; 12 (01) 43-60
    CrossrefPubMedGoogle Scholar
  • 22 Kania K, Byrnes EA, Beilby JP, Webb SA, Strong KJ. Urinary proteases degrade albumin: implications for measurement of albuminuria in stored samples. Ann Clin Biochem 2010; 47 (Pt 2): 151-157
    CrossrefPubMedGoogle Scholar
  • 23 Ma RX, Xu Y, Zhang J, Li YS, Liu LQ. Triptolide combined with irbesartan synergistically blocks podocyte injury in a type 2 diabetes rat model [in Chinese]. Zhonghua Nei Ke Za Zhi 2012; 51 (02) 117-122
    PubMedGoogle Scholar
  • 24 Kondapi K, Santhi S, Swathy M. Diagnostic sensitivity of biomarkers in assessing the occurrence and progression of diabetic nephropathy. Eur J Mol Clin Med 2021; 8 (03) 1-18
    Google Scholar
  • 25 Yadav BK, Adhikari S, Gyawali P, Shrestha R, Poudel B, Khanal M. Use of protein: creatinine ratio in a random spot urine sample for predicting significant proteinuria in diabetes mellitus. Nepal Med Coll J 2010; 12 (02) 100-105
    PubMedGoogle Scholar
  • 26 Ng DP, Tai BC, Tan E. et al. Nephrinuria associates with multiple renal traits in type 2 diabetes. Nephrol Dial Transplant 2011; 26 (08) 2508-2514
    CrossrefPubMedGoogle Scholar
  • 27 Toyoda M, Suzuki D, Umezono T. et al. Expression of human nephrin mRNA in diabetic nephropathy. Nephrol Dial Transplant 2004; 19 (02) 380-385
    CrossrefPubMedGoogle Scholar
  • 28 Petrica L, Vlad A, Gluhovschi G. et al. Proximal tubule dysfunction is associated with podocyte damage biomarkers nephrin and vascular endothelial growth factor in type 2 diabetes mellitus patients: a cross-sectional study. PLoS One 2014; 9 (11) e112538
    CrossrefPubMedGoogle Scholar
  • 29 Bobkova IN, Shchukina AA, Shestakova MV. Assessment of nephrin and podocin levels in the urine of patients with diabetes mellitus. Nephrology (Saint-Petersburg) 2017; 21 (02) 33-40
    CrossrefGoogle Scholar