Early Prediction of Nephropathy in Iraqi Patient with Diabetes Type II by Evaluating Some Relevant Biochemical Factors

Abstract

Type 2 diabetes mellitus (T2DM) is a complex disease, which affects many organs besides the pancreas such as the kidney, liver, brain and eye. Due to hyperglycemia at long periods and uncontrolled on diabetes with presence of other risk factors, diabetes complications could occurr. Diabetes complications include microvascular and macrovascular complications that target the kidneys. The aim of this study is to predict early fibrosis of the renal glomeruli and tubules by evaluating the levels of angiotensin-converting enzyme -2(ACE-2), connective tissue growth factor (CTGF) and some relevant biochemical factors in patients with type 2 diabetes. The study included 120 male and female ranging in age 30-65 years old, they were subdivided into three groups according to ACR criteria include normoalbuminuria, microalbuminuria, macroalbuminuria (30 patients for each group) and 30 healthy people served as the control group, who visited Baghdad Teaching Hospital / Medical City and Al-Yarmouk Teaching Hospital, at the period between December 2021 and May 2022. Lipid profile, FBS, urea levels were estimated using calorimetric techniques. ACE-2, CTGF levels were determined using the ELISA technique. The results showed significant differences between groups of patients and control group for (CTGF), (ACE-2) levels were found to be significant increase in patients’ groups than healthy control. Also, the results showed that both fasting blood sugar (FBS) and hemoglobin A1c (HbA1C) were significantly increased in patients’ groups compared to healthy group. Furthermore, estimated glomerular filtration rate (eGFR) revealed high significant differences among all the studied groups, as well as albumin to creatinine ratio (ACR) which showed high significant differences among the three patients’ groups which represents the basic criteria for classification of patient groups. On the basis of the obtained results in this study, it can be concluded that each of ACE-2 and CTGF markers can be applied as early reliable prognosticated factors for detection disease progression.

Keywords

• Angiotensin converting enzyme-2, albumin to creatinine ratio, connective tissue growth factor, Diabetes Mellitus. Diabetic Nephropathy