Role of Angiopoietin like protein-8 as a predictive marker of diabetic nephropathy in type 2 diabetes mellitus

Background: Diabetic nephropathy is a critical complication of T2DM. Its prevalence is 30-40% of individuals with long-standing T2DM. DN can cause damage to the small blood vessels of the kidneys impairing their functions in filtering waste and excess fluids from the blood that may ultimately lead to end-stage kidney disease (ESKD). Although several markers are available for diagnosis of DN, it is important to find better markers for better clinical management. Angiopoietin like protein-8 (ANGPTL8) is produced in the liver and adipose tissue. It has role in regulation in lipid metabolism and regulation of insulin sensitivity. Aim: To evaluate serum level of ANGPTL8 in patients diagnosed with DN and to investigate the relation between ANGPTL8 and severity of DN. Methods: The study was conducted on 80 subjects divided into 60 patients diagnosed with T2DM with DN and 20 patients diagnosed with T2DM without DN as a control group, All patients undergo Complete medical examination, radiographic imaging (including renal ultrasonography) and laboratory testing including FBG, HbA1c,urea, creatinine,eGFR, AST, ALT, albumin,lipid profile, CRP, serum ferritin, A/C ratio and serum ANGPTL8. Results: Serum ANGPTL8 levels showed statistically significant increase in patients with diabetic nephropathy compared to those without, and were independently associated with markers of proteinuria (ACR) and hypoalbuminemia. Although no significant correlation was observed with glycemic control markers or renal filtration parameters (eGFR, serum creatinine). Conclusion: Serum level of ANGPTL8 was higher among patients with DN which highlights its value in DN progression and were independently associated with markers of proteinuria (ACR) and hypoalbuminemia. it could be an early predictor for DN.