Serum Cystatin C and Tubular Urinary Enzymes as Biomarkers of Renal Dysfunction in Type 2 Diabetes Mellitus

Abstract

Renal tubulointerstitium plays an important role in the development and progression of diabetic nephropathy. The aim of this study was to assess serum cystatin C and 2 renal tubular enzymes, neutrophil gelatinase associated lipocalin (NGAL) and N-acetyl-beta-D-glucosaminidase (NAG), as screening markers for early renal dysfunction in patients with type 2 diabetes mellitus (T2DM). ROC curve analysis showed that urinary NAG is the most sensitive marker of microalbuminuria and early renal damage with sensitivity of 83.3%, while serum cystatin C was the most sensitive and specific marker of macroalbuminuria and damage progress with sensitivity of 70.8% and specificity of 83.3% versus 70.6% and 83.3% for uNGAL; and 64.7% and 66.7% for NAG, respectively. Our data indicate that urinary NAG is the most sensitive marker for early renal damage in diabetic patients. However, for damage progress, serum cystatin C is the most sensitive and specific marker for follow-up and monitoring renal dysfunction.

The ameliorative potential of Hyphaene thebaica on streptozotocin-induced diabetic nephropathy

“…For these, tubular damage markers, such as serum and urinary Cys C and NGAL, can be used as early predictors of DN [14,27]. Kim et al [20] found an increased serum Cys C in patients with DN, which is in accordance with the findings of this study, and Nauta et al [30] found that DN patients have an increased serum levels of both serum Cys C and NGAL [5,30].…”

Kim-1 and Ngal as Biomarkers of Nephropathy in Type Ii Diabetes.

“…(19) In contrast to Assalʼs (20) study who found a significant correlation between urine NGAL and serum creatinine, our study was in line with Zachwieja et al (18) showed no statistically significant correlation with serum creatinine and eGFR. This can be referred to that our study excluded severe renal impaired patients.…”

Novel Biomarkers for Early Diagnosis and Progression of Diabetic Nephropathy

“…A newly published report showed that serum cystatin-C based equation was less biased and could predict GFR changes better than the MDRD equation (Beauvieux et al 2007). Another study showed that cystatin-C is the most sensitive and specific marker in DN for the follow-up and monitoring renal damage progression (Assal et al 2013). Taken together, these findings indicated that serum cystatin-C could be a replacement to serum creatinine for measuring GFR in diabetic patients.…”