The Pathogenic and Developmental Biomarker: High Sensitivity C-Reactive Protein in Early Diagnosis of Diabetic Nephropathy

Abstract

Introduction: Type 2 Diabetes Mellitus (T2DM) is one of the chronic metabolic conditions leading to various complications and most commonly Diabetic Nephropathy (DN). DN imposes a major and unrecognised burden to the whole world in the management of health system and economy. High sensitivity C-Reactive Protein (hs-CRP), being an inflammatory marker, plays a pathogenic role in DN and found to be increased in diabetes patients. Aim: To determine an earlier pathogenic marker for DN among T2DM patients. Materials and Methods: This cross-sectional study was conducted among 92 clinically diagnosed T2DM patients. Written informed consent was obtained. Blood samples were collected and analysed for Fasting Blood Sugar (FBS), hsCRP. Spot urine microalbumin creatinine ratio was estimated by immunoturbidimetry and Jaffe’s method, respectively. Data was statistically analysed using student t-test and correlation between analytes was analysed using Pearson correlation. Results: Mean serum hs-CRP value of diabetic subjects with microalbuminuria was 6.9±3.2 mg/L and diabetic subjects without microalbuminuria was 1.4±0.68 mg/L. There was a positive correlation between hs-CRP and Urine Albumin Creatinine Ratio (UACR) (r=0.47; p=0.02). There was also a positive correlation between hs-CRP and FBS levels and hs-CRP and duration of type 2 diabetes mellitus. The hs-CRP and UACR were elevated among type 2 diabetic patients. There was a positive correlation between hs-CRP and FBS and duration of diabetes mellitus. Conclusion: As hyperglycaemia plays a critical pathogenic role in type 2 diabetes through the inflammatory pathway, hs-CRP may be suggested as a developmental biomarker of DN among T2DM patients in association with UACR.

Keywords

• diabetic kidney disease
• fasting blood sugar
• urine microalbumin creatinine ratio