The Role of Transferrin and Laminin Biomarkers in the Diagnosis of Diabetic Nephropathy in Type II Diabetic Patients

Abstract

Background/Aim: Diabetic nephropathy is one of the most important microvascular complications associated with type II diabetic patients. It occurs in 20-40% patients with diabetes mellitus, and microalbuminuria is still considered as the first sign of diabetic nephropathy. Low sensitivity and specificity of microalbuminuria leads to more sensitive biomarkers that may be used to detect diabetic nephropathy at an earlier stage with higher accuracy. This study was carried out to detect the validity of using serum Transferrin and Laminin as a diagnostic biomarkers for diabetic nephropathy in type ΙΙ diabetic patients. Methods: Egyptian patients (n=96) included 72 type 2 diabetic patients who were classified into three groups: group 1 - normoalbuminuric patients (uACR up to 30 mg/g), group 2 - microalbuminuric patients (uACR from 30 – 300 mg/g), group 3 - macroalbuminuric patients (uACR from >300 mg/g) and 24 healthy control were surveyed in a cross-sectional study over a period of 6 months at biochemistry department, KASR ALAINY Hospital of Cairo University. Patients were subjected to measurement of Albumin creatinine ratio, eGFR, Serum creatinine, glycosylated hemoglobin (HbA1c) and lipid profile. The serum concentrations of transferrin and lamnin were measured using a highly sensitive one-step sandwich enzyme immunoassay kit. Results: Serum laminin was significantly higher in macroalbuminuric patients than in the microalbuminuric and in microalbuminuric patients than in the normoalbuminuric and healthy control subject. By comparing these goups according to serum laminin concentration we found statistically significant positive correlation (p value <0.001, r= 0.670), serum transferrin was significantly lower in macroalbuminuric patients than in the microalbuminuric and in microalbuminuric patients than in the normoalbuminuric and healthy control subject. By comparing these goups according to serum transferrin concentration we found statistically significant inverse correlation (p value <0.001, r= -0.579). There was no correlation between level of serum transferrin /laminin and glycoregulation, and statistically significant positive correlation was found between serum laminin and duration of diabetes and statistically significant inverse correlation was found between serum transferrin and duration of diabetes. Conclusions: The results from this study provide the evidence that serum laminin and transferrin could be used as a diagnostic markers of diabetic nephropathy.