Retinol Binding Protein 4 as a Recent Biomarker for Prediction of Diabetic Nephropathy in Type 2 Diabetic Patients

Abstract

Diabetic Nephropathy, which is one of the most common and severe microvascular complications of diabetes, accounts for not only the leading cause of end-stage renal disease but also causes major morbidity and mortality in patients with type 2 diabetes. However, DN often occurs with no obvious symptoms in the early stage. We aim to evaluate the role of RBP4 as a recent biomarker for the prediction of diabetic nephropathy in type 2 diabetic patients. This study was conducted on 60 patients with type П diabetes mellitus considered as Group A which was subdivided into 2 subgroups, Group A1: 30 type П diabetic patients without albuminuria, Group A2: 30 type П diabetic patients with albuminuria and 30 age and sex matched healthy individuals Group B considered as control group. There is statistically significant increase of serum RBP4 level in diabetic patients when compared to control group. There is statistically significant increase of serum RBP4 level in diabetic patient groupA2 when compared to diabetic patients group A1 and between each subgroup when compared with control. There is also significant difference between patient and control as regard to the inflammatory marker Hs CRP with also significant difference in patients' subgroups. Even though that tubular damage marker such as serum RBP4 as single diagnostic parameter of renal impairment showed good clinical accuracy, we aim to clarify that combination of markers of tubular damage (RBP4), inflammation markers (HsCRP) and traditional markers has the higher sensitivity and specificity than each single marker alone in prediction of DN. There is a strong positive correlation between serum level of RBP4 and serum urea, creatinine and Alb/creat ratio while negative correlation with eGFR and serum albumin level. There is also a positive correlation between serum level of RBP4 and HsCRP level. Serum level of RBP4 was higher in type П diabetic patients compared to control group and it increased in diabetic patients with micro albuminuria more than diabetic patients without micro albuminuria.