Biomarkers of renal dysfunction among Ghanaian patients with type 2 diabetes mellitus- a cross-sectional study
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Type 2 diabetes mellitus (T2DM) is a heterogeneous collection of disorders characterized by reduced insulin sensitivity and increased glucose output. The abnormal vascular architecture observed within the first few years of diabetes onset suggests that complications such as nephropathy develop earlier in affected individuals than is generally known. Prompt determination of decline in renal function among diabetics is therefore very crucial. In the present study, we evaluated circulating levels of adiponectin, neutrophil gelatinase-associated lipocalin (NGAL), asymmetric dimethyl arginine (ADMA), and endothelial nitric oxide synthase traffic inducer (NOSTRIN) as novel biomarkers of renal dysfunction. One hundred and eight Ghanaian patients with T2DM were recruited for this study. Biochemical and immunoassays were employed in measuring the levels of the biomarkers for all participants. Metabolic syndrome indices including body mass index (BMI), serum glucose, and uric acid levels were not found to be associated with adiponectin concentrations. Fifteen participants had normal estimated glomerular filtration rate (eGFR), 79 had a mildly reduced eGFR, and 24 had moderately reduced eGFR representing 12.8, 66.9, and 20.3%, respectively. Proteinuria correlated significantly with decreasing eGFR. Serum levels of adiponectin, ADMA, and NOSTRIN (p = 0.002; p = 0.001; p = 0.012, respectively) were, however, found to be independently associated with estimated glomerular filtration rate (eGFR) among the type 2 diabetics. We observed that elevated circulating levels of adiponectin, ADMA, and NOSTRIN could be important in characterizing early CKD stages among type 2 diabetics.
KeywordsBiomarkers Type 2 diabetes Complications Nephropathy
Body mass index
Chronic kidney disease
Estimated glomerular filtration rate
Endothelial nitric oxide synthase
Enzyme-linked immunosorbent assay
Free fatty acid
Modification of diet in renal disease
Neutrophil gelatinase-associated lipocalin
Endothelial nitric oxide synthase traffic inducer
Type 2 diabetes mellitus
We wish to express our sincere appreciation to the entire staff of the National Diabetes Management and Research Centre, Ghana.
ABY made extensive contributions to the concept and design of this study and also participated in the laboratory analyses of study samples as well as data interpretation.
AGA contributed to the design of the study and also provided considerable support for the laboratory analyses.
YFA assisted in designing this study and also provided logistical support for laboratory analyses.
OC was involved in in the analyses of data and drafting of the manuscript.
AB was involved in the laboratory analyses of the work and also processed, analyzed, and interpreted data.
AOM made substantial contributions to the sampling of participants, acquisition of data, and laboratory analyses.
AEA was involved in the recruitment of and blood sampling of study participants, acquisition of data, and laboratory analyses.
This project was carried out with the financial support of the office of research, innovation and development (ORID) of the University of Ghana. The funder, however, did not have any role in the design of the study, data collection, or in preparation of the manuscript.
Compliance with ethical standards
Ethics approval and consent to participate
Ethics clearance was obtained from NDMRC prior to the commencement of this study. Anthropometric measurements, blood samples, and records from hospital folders were collected after obtaining a written informed consent from subjects who volunteered to participate in the study. All data were kept confidential throughout the study.
The authors have declared that no competing interest exists.
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