Evaluation of neutrophil gelatinase associated lipocalin (NGAL) in type 2 diabetic patients with diabetic nephropathy

Abstract

Diabetic nephropathy (DN) is a devastating chronic microvascular complication that represents the major cause of end-stage renal failure leading to the development and progression of diabetic syndrome.

Aim: The aim of this study was to evaluate serum neutrophil gelatinase associated lipocalin (NGAL) in type 2 DM with diabetic nephropathy.

Methods: Eighty (80) type 2 diabetic patients with DN and apparently healthy controls were respectively recruited. Blood samples were collected and tested for serum NGAL, creatinine, albumin, fasting plasma glucose and HbA1c. Creatinine and albumin were analyzed using Abbot autoanalyser, HbA1c was analyzed using fine care system and serum NGAL using the ELISA method. Estimated GFR (eGFR) was calculated using the modification of diet in renal disease (MDRD) formula. Statistical analysis was performed using statistical package for social science (SPSS) software version 20.0. Student t-test, one way analysis of variance (ANOVA) and Pearson’s correlation were used for comparisons and correlation of data respectively with level of significance set <0.05.

Result: The mean values of the serum NGAL, FPG, HbA1c, BMI and eGFR in both DN group and control group were found to be 3.72±2.62 vs 1.08±0.78μg/ml, 7.06 ±3.46 vs 4.08± 0.39mmo/l, 6.73±1.08 vs 4.71 ±0.39%, 27.33±5.29 vs 25.08±3.65ml/min/1.73m2 and 76.57 ±11.20 vs 118.23 ±12.11ml/min/1.73m2 respectively. The study found a high and significant difference in the mean values of the DN group compared to the control group. A positive and significant relationship was observed between serum NGAL and eGFR and duration of diagnosis of diabetes mellitus.

Conclusion: Serum NGAL could therefore be used as a biomarker to diagnose DN even earlier to incipient nephropathy, NGAL, Diabetes nephropathy, eGFR, Microalbuminuria, Glycated haemoglobin.