NGAL (Neutrophil Gelatinase-Associated Lipocalin) as an early biomarker of nephropathy in patients with type 2 diabetes

Abstract

ABSTRACTBackground and aim Diabetic nephropathy (DN) is a major microvascular diabetic complication representing the key leading reason for end-stage renal disease (ESRD). The current work aimed to evaluate the value of urinary and serum NGAL (neutrophil gelatinase-associating lipocalin), as an early biomarker of DN in subjects with type-2 diabetes mellitus (T2DM).Methods The study included 300 adult subjects with T2DM subdivided into 3 groups: Group A: 100 subjects with normoalbuminuria. Group B: 100 subjects with moderately increased albuminuria. Group C: 100 subjects with severely increased albuminuria.Results Serum NGAL and urinary NGAL were significantly elevated in T2DMsubjects with albuminuria than in normoalbuminuric T2DMsubjects (p < 0.001). Serum NGAL and urinary NGAL were positively associated with albumin/creatinine Ratio, (p < 0.001). ROC curve analysis was done to discriminate among moderately/severely increased albuminuria from normoalbuminuria showed a cutoff point ≤ 10.76 for serum NGAL with AUC 0.785 (p value < 0.001) and a cutoff point ≤ 15.811 with AUC 0.687 for urinary NGAL(p < 0.001).Conclusion NGAL can be utilized as a biomarker for the early diagnosis of DN. Both urinary NGAL and serum NGAL may predict albuminuria and can be utilized as a noninvasive tool for diagnosing, grading, and progressions of DN.

Keywords

• Diabetic nephropathy
• albuminuria
• neutrophil gelatinase-associated lipocalin