Resistin Level as a Marker of Malnutrition in Diabetic Patients With Chronic Kidney Disease

Background: Malnutrition is a frequent and serious issue in chronic kidney disease (CKD), especially in diabetic patients, and resistin has been suggested as a biomarker linked to insulin resistance, inflammation, and declining nutritional status. Objective: To evaluate the role of serum resistin as a marker of malnutrition in diabetic cases with chronic kidney disease. Patients and Methods: This prospective comparative research included 110 diabetic cases with chronic kidney disease recruited from Menoufia University and Shebeen El-Kom Teaching Hospitals. Patients were classified into two groups based on the Subjective Global Assessment (SGA): Group A (well-nourished, n = 55) and Group B (malnourished, n = 55). Resistin concentrations were calculated utilizing enzyme-linked immunosorbent assay (ELISA). Insulin resistance was assessed applying the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Other laboratory markers included protein-to-creatinine ratio, aspartate aminotransferase (AST), and total iron-binding capacity (TIBC). Results: Malnourished patients were significantly older (61.4 ± 11.9 vs. 57.2 ± 8.3 years, p = 0.03) and had an elevated occurrence of hypertension and autosomal dominant polycystic kidney disease. They demonstrated greater weight loss, decreased dietary intake, and reduced functional capacity (all p < 0.001). Laboratory findings showed higher levels of HOMA-IR, protein-to-creatinine ratio, AST, TIBC, and markedly elevated resistin (31.1 ± 8.8 vs. 5.37 ± 1.8 ng/mL, p < 0.001). Conclusion: Serum resistin is markedly higher in malnourished diabetic CKD patients and correlates with worsening nutritional and metabolic status, suggesting its value as an early marker of malnutrition.