Evaluation of Serum Beta-trace Protein for Identifying Nephropathy in Type 2 Diabetes Mellitus

Background: Diabetic nephropathy (DN) is one of the most serious and prevalent consequences associated with diabetes mellitus (DM) and is the major factor in the development of end-stage renal disease. The diagnosis is established when there is a sustained presence of elevated albuminuria and a decline in the estimated glomerular filtration rate (eGFR), in which microalbuminuria (MAU) is considered the marker of early-stage nephropathy that reflects the glomerular damage. However, a significant number of diabetic patients have been reported to experience renal insufficiency without accompanying glomerular alterations. This study intends to assess the outcome of beta-trace protein (BTP) and its potential in facilitating the timely diagnosis of nephropathy. Methods: The study was undertaken on 180 participants categorized into four groups based on their albuminuria levels: Group I, healthy individuals; Group II, type 2 DM (T 2 DM) with normoalbuminuria; Group III, T 2 DM with MAU; and Group IV, T 2 DM with macroalbuminuria. All the patients were investigated for serum BTP, urinary albumin, and traditional markers of nephropathy. Results: Serum levels of BTP were substantially elevated in diabetic patients compared to healthy individuals. The mean ± standard deviation progressively raised among the normoalbuminuric group of diabetic patients (804.10 ± 319.173 ng/mL) and reached the peak in patients exhibiting macroalbuminuria (1015.84 ± 234.03 ng/mL). There was a significant positive correlation of BTP with albuminuria as well as glucose, glycated hemoglobin, creatinine, and inverse correlation with eGFR. Receiver Operating Characteristic (ROC) analysis showed area under the curve of 0.737 (95% confidence interval: 0.663–0.811) with a sensitivity of 83.58% and a specificity of 61.95%. Conclusion: The serum BTP level is elevated among patients with diabetes and is notably increased in those with nephropathy. The rise occurs even before the development of microalbuminuria, suggesting that BTP serves as a valuable biomarker for the early identification of nephropathy in patients with diabetes.