Urinary Nephrin as a Marker of Nephropathy in Obese Prediabetic Patients

Abstract

Systemic insulin resistance is a decreased glucose disposal rate in humans in response to defined concentrations of insulin. Systemic insulin resistance can result from impaired insulin action in metabolically active organs and tissues, including skeletal muscle, the liver, and adipose tissue. The degree to which systemic insulin resistance is due to impaired insulin action in skeletal muscle, liver, or adipose tissue may vary among individuals (Hall et al., 2020). “Prediabetes” refers to IFG, IGT or an A1C of 6.0% to 6.4%, each of which places individuals at high risk of developing diabetes and its complications. Not all people with pre-diabetes will develop diabetes, but the majority will. In fact, up to 70% of those with pre-diabetes may acquire the disease over their lifetime. Furthermore, even when overt diabetes is delayed or prevented, both micro- and macrovascular disease appears more prevalent in those with pre-diabetes compared to their normoglycemic peers (Punthakee et al., 2018). Obesity and overweight are defined as abnormal or excessive fat accumulation that presents a risk to health. The body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2). A person with a BMI of 25 Kg/m2 or more is considered by WHO to be overweight,