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Among the side effects of diabetes mellitus is diabetic nephropathy, the main reason for end-stage kidney disease linked to increased mortality and morbidity. Early diagnostic biomarkers for diabetic nephropathy are required to stop or even slow down the progression of the disease and to administer the most appropriate protective treatments on time. Therefore, it is essential to study additional potential biomarkers for the early diagnosis of diabetic nephropathy. This study aims to evaluate elabela, FABP1, and FABP2 levels synergistically as a new diagnostic tool for the early detection of diabetic nephropathy in type 2 diabetic patients. This study was conducted on 95 subjects (75 patients with type 2 diabetes and 20 healthy controls). Type 2 diabetic patients were divided based on their urinary ACR into three groups: normal albuminuria, microalbuminuria (early nephropathy), and macroalbuminuria (overt nephropathy), and compared to healthy controls. Serum elabela, FABP1, and FABP2 levels and some biochemical parameters were evaluated. The level of serum elabela significantly decreased (P < 0.05), while FABP1 and FABP2 levels significantly increased (P < 0.05) with the increase in the severity of diabetic nephropathy compared to the control group. There were significant negative correlations between elabela and FABP1, FABP2, and urinary ACR and significant positive correlations with eGFR in all patient groups. FABP1 and FABP2 levels showed significant negative correlations with eGFR and significant positive correlations with urinary ACR. Multiple linear regression analysis illustrated a significant effect of urinary ACR on the three biomarkers in all studied groups. ROC curve analysis demonstrated that the combination of elabela, FABP1, and FABP2 had the highest diagnostic performance with an AUC of 1.0 (P = 0.001), and the sensitivity and specificity reached 100% in all patient groups compared to the control group. In conclusion, elabela, FABP1, and FABP2 may be potential new biomarkers of diabetic nephropathy. Combining these three biomarkers can be used synergistically as a diagnostic tool for the early diagnosis of diabetic nephropathy in type 2 diabetic patients.

The online version contains supplementary material available at 10.1007/s12291-024-01231-x.