Diagnostic and predictive utility of serum homocysteine in diabetic nephropathy among type 2 diabetics

Background: Diabetic nephropathy (DN) is a leading cause of end-stage renal disease (ESRD) in patients with type 2 diabetes mellitus (T2DM). Early detection of DN is crucial for effective intervention, yet current biomarkers have limited sensitivity and specificity. Serum homocysteine, has been associated with vascular complications in diabetes and is hypothesized to be linked with DN. This study investigates the potential of elevated serum homocysteine levels as a marker for DN in T2DM patients. Methods: A cross-sectional study was conducted involving 156 T2DM patients recruited from G. S. V. M. medical college, Kanpur. The inclusion criteria focused on adult patients with a confirmed diagnosis of T2DM. Exclusion criteria included conditions that could independently affect homocysteine levels or renal function. Statistical analyses were employed to assess the relationship between homocysteine levels and DN. Results: The study found significantly higher homocysteine levels in patients with DN compared to those without DN. A positive correlation was observed between serum homocysteine levels and the severity of renal impairment, as indicated by a decline in glomerular filtration rate (GFR) and increased albuminuria. Logistic regression analysis confirmed that elevated serum homocysteine levels were an independent predictor of DN. Conclusions: Elevated serum homocysteine levels are significantly associated with DN in T2DM patients and may serve as a useful biomarker for early detection and management of this complication. Given the limitations of current biomarkers, incorporating homocysteine measurements could improve the clinical management of patients at risk for DN.