Urinary Neutrophil Gelatinase Associated Lipocalin (NGAL) as an Early marker of Nephropathy In Type 2 Diabetic Patients

Abstract

T he prevalence of diabetes mellitus is rising worldwide and its severe complications, such as diabetic nephropathy, affect an increasing number of patients. Hence, the need for reliable diagnostic tools and treatment strategies grows. However, sensitive markers to detect very early changes in kidney function and kidney injury are sparse. Even urinary albumin excretion, which is being widely accepted as one of the earliest and most sensitive markers detecting renal damage and predicting further cardiovascular morbidity, does not necessarily uncover renally impaired patients. Consequently, the need for further biomarkers which reflect the stage and course of diabetic nephropathy is still high. This study focuses on Neutrophil gelatinase-associated lipocalin (NGAL) in urine. This protein has been recently reported to be promising new biomarker with the ability to reflect renal damage and impairment in diabetic patients. Our study was conducted on 80 subjects, Gr I = 20 patients with T2DM with normoalbuminuria (albuminuria<30 mg/g), Gr II = 20 patients with T2DM with microalbuminuria (albuminuria 30-300 mg/g). Gr III = 20 patients with T2DM with macroalbuminuria (albuminuria >300 mg/g) and Gr V = 20 healthy normal control subjects.

They were selected from Endocrinology clinic after written consent at Ain Shams University Hospital. All participants were subjected to full medical history taking, general clinical examination and laboratory investigations including (complete blood picture, ALT, AST, fasting plasma glucose, two hours post prandial plasma glucose, HbA1c, lipid profile, albumin creatinine ratio and measurement of urinary neutrophil gelatinase associated lipocalin in urine). Patients with Type 1 D.M, chronic systemic diseases such as renal failure, liver cell failure were excluded from our study.