Comparative Study on Nephrin, Transforming Growth Factor-β and Some Biochemical Markers for Predicting Type 2 Diabetic Nephropathy

Background: Diabetic Nephropathy (DN), is a microvascular complication of the diabetes mellitus type 1 or 2 and the major reason of end-stage kidney disease, which is distinguished by an increase in urine albumin excretion (microalbuminuria) and/or a decreased glomerular filtration rate (GFR) or both. Microalbuminuria has limited diagnostic role in early-stage diabetic nephropathy, because renal damage usually occurs before proteinuria. Therefore, more sensitive and specific biomarkers are needed for early detection of Diabetic Nephropathy. Materials and Methods: A case-control study involved 180 participants aged 40-≥70 years, 60 individuals were healthy, and 120 had type 2 DM. The participants were divided into three groups according to the urinary albumin/ creatinine ratio (ACR): 40 patients with normoalbuminuria, 40 patients with microalbuminuria, and 40 patients with macroalbuminuria. Results: The diabetic nephropathy was found in male more than female and the majority of patients were in age group 60-≥70 years. A significant difference in mean ± SD of age, Body mass index (BMI), and duration of diabetes P ≤ 0.001, macroalbuminuria, microalbuminuria, and normoalbuminuria groups show a statistically higher serum nephrin and TGF-β in comparison to the healthy controls. Nephrin and TGF-β are strongly associated with blood urea and serum creatinine and an inversely associated with the glomerular filtration rate in all diabetic groups. Receiver operating characteristic (ROC) curve analysis for DN detection. Nephrin and TGF-β showed high sensitivity and specificity. Conclusion: Elevated levels of nephrin and TGF-β in type 2 diabetic patients have been reported in the current study. These findings proposed that nephrin and TGF-β could be an early diagnostic markers for detection of diabetic nephropathy.