U-LFABP AS A PREDICTIVE MARKER FOR PROGNOSIS OF DIABETIC KIDNEY DISEASE IN EGYPTIAN PATIENTS
Eman M. Abd El Azeem*, Dina M. Seoudi, Mustafa I. Hassanein and Marwa A. Hussein
ABSTRACT
This study was aimed to evaluate the level of urinary liver-type fatty acid binding protein (u-LFABP) as a marker of diabetic kidney disease and to study its correlation with other kidney parameters in Egyptian patients with chronic type 2 diabetes mellitus (T2DM). A total of 70 T2DM subjects were divided into three groups: diabetics with normal kidney function and normal blood pressure (DM; 20 patients), diabetics with microalbuminureia and high blood pressure (early-DN; early diabetic nephropathy) (20patients) and diabetic kidney disease (DKD) with microalbuminuria and high blood pressure (30 patients), with 20 non-diabetic control subjects. U-LFABP levels were measured by ELISA technique. Results showed that u-LFABP level was highly significant increased (P<0.001), this increase was more pronounced in early DN group and in DKD patients compared to normal control indicating tubular damage. The levels of u-LFABP increased gradually with declining renal function and reduced e-GFR. U-LFABP showed a positive correlation with s- creatinine, UAER and IL-6 (r 0.55, 0.32 and 0.56; respectively) and a significant negative correlation with e-GFR (r= 0.54, P<0.05) in the early DN patients’ group. In DkD patients’ group a significant positive correlation was recorded between u-LFABP and fasting plasma glucose, HbA1c, fasting insulin, s- creatinine, UAER and IL-6 (r= 0.35, 0.57. 0.45, 0. 67, 0.70 and 0.77; respectively) and negative correlation with e-GFR (r= 0.66, P<0.001). As a result of receiver operating characteristic (ROC) analysis, u-LFABP appeared to be a more sensitive marker for the detection of early-DN and also for the prediction of DKD progression in diabetic patients.
Keywords: Diabetic nephropathy, u-LFABP, diabetic kidney disease.
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