Relationship between Serum Asprosin and Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus

Background: Diabetic kidney disease (DKD) is a major cause of end-stage renal disease (ESRD) in type 2 diabetes mellitus (T2DM). Traditional markers such as albuminuria and eGFR often indicate renal injury only after irreversible damage. Asprosin, a fasting-induced adipokine linked to insulin resistance, hyperglycemia, and inflammation, may serve as an early biomarker for diabetic kidney injury. Aim: This study aimed to assess serum asprosin levels in T2DM cases with and without diabetic nephropathy (DN) and to explore their relationship with, urine albumin-to creatinine ratio (UACR) and eGFR. Methods: In this cross-sectional analysis, 80 subjects were equally distributed into four groups: healthy control (Group I), T2DM cases without nephropathy (Group II), those with microalbuminuria (Group III) and those with macroalbuminuria (Group IV). Clinical, biochemical, and ultrasonographic assessments were conducted and serum asprosin concentration was measured by ELISA. Results: Mean serum asprosin levels were significantly higher in group IV (131.48 ng/ml) than in groups I (26.04 ng/ml), II (30.87 ng/ml), and III (42.55 ng/ml) (P<0.001). Asprosin discriminated nephropathy (micro- and macroalbuminuria) from normoalbuminuria with an AUC of 0.955, sensitivity 95.0% and specificity 87.5% at a cut-off > 32.26 ng/ml. Asprosin showed substantial positive correlations with waist circumference (WC), BMI, serum urea, creatinine, UACR, HbA1c, FBS, HOMA-IR, and TGs, and a marked negative correlation with eGFR (all P < 0.05). Multivariate analysis identified serum urea, creatinine, UACR, and HbA1c as independent predictors of asprosin. Conclusions: Higher serum asprosin levels observed in T2DM cases with nephropathy were significantly linked to parameters of renal dysfunction and altered metabolic status, underscoring its value as a potential early indicator of DKD.