INTRODUCTION : Diabetic Nephropathy (DN) is the leading reason of all excess death-rate over type-2 diabetes mellitus (T2DM) patients with microalbuminuria, macroalbuminuria or end-stage renal disease. This work was aimed to estimate insulin resistance (IR) effect on some markers and trace elements (Selenium, Zinc, Magnesium) levels for early predicting of DN in T2DM patients. METHODS : We conducted a cross-sectional clinical study. Blood and urine samples were collected from 63 subjects with T2DM and 33 healthy controls to assess glucose, insulin, IR, urea, creatinine, glomerular filtration rate (GFR), creatinine clearance (CrCl), homocysteine (Hcy), fructosamine (FA), cystatin C (CysC), albumin (Alb), neutrophil gelatinase-associated lipocalin (NGAL), 8-hydroxy-2`-deoxyguanosine (8-OHdG) and trace elements levels. Data were collected using a questionnaire that was filled out by specialized doctors. RESULTS : Compared with controls, the results revealed that T2DM patients with or without DN had significant increases in glucose, insulin, IR, urea, creatinine, Hcy, FA, CysC, Alb, NGAL and 8-OHdG and significant decreases in GFR, CrCl and trace elements levels. Body mass index (BMI) had no changes. CONCLUSION : Uncontrolled T2DM was associated with BMI, IR and physical activity in which elevated Hcy, FA, CysC, Alb, NGAL and 8-OHdG levels and decreased trace elements levels may be used as early clinical markers of DN.

Diabetic nephropathy (DN) is a master cause of all surplus death-rate among type 2 diabetes mellitus (T2DM) patients with microalbuminuria. This study aimed to find effective biomarkers for early predicting of DN. Present study included 63 patients with T2DM (31 patients with DN, 32 patients without DN) and 33 healthy controls. These three groups were matched for their glucose, urea, creatinine, insulin, L-Carnitine (LC), osteoprotegerin (OPG), sialic acid (SA), trace elements (Selenium, Zinc, Magnesium), albumin (Alb), and fibronectin (FN). Glucose, urea, and creatinine were determined by spectrophotometer. Insulin, LC, OPG, SA, Alb, and FN were assayed by enzyme-linked immunosorbent assay (ELISA). Insulin resistance (IR) was calculated by the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) equation. Selenium was measured by hydride generation while Zinc and Magnesium were measured by flame atomic absorption spectrometer. Compared with controls, the results indicated that T2DM patients with or without DN had a significant increase in glucose, urea, creatinine, insulin, IR, OPG, SA, Alb, FN and a significant decrease in LC and trace elements levels. It was concluded that IR is strongly associated with obesity and had an important role in the pathogenesis and increased complication of diabetes which could be used as excellent indicators for early-stage DN in T2DM patients and thus decreasing mortality and morbidity.