Assessing the clinical utility of DPP-IV, AMBP and HP-15 exosomes biomarkers for early detection of diabetic nephropathy in Jigawa, Nigeria

Abstract

Background: Diabetic nephropathy (DN) with multifactorial pathogenesis is a debilitating complication of diabetes causing  socioeconomic burden and reduced quality of life. The emerging urinary exosomes (UEs) are proposed new biomarkers among patients  with DN.

Aim: This study aimed at assessing UEs for their clinical utility as potential early diagnostic markers among diabetic patients to prevent or  delay the development diabetic nephropathy

Methods: The study recruited 86 Type 2 Diabetic (T2DM) patients attending diabetic clinic at RSTH Dutse, and 86 subjects as controls.  Dipeptidyl Peptidase IV (DPPIV), Histone lysine N methyltransferase (HP15) and Alpha 1 microglobulin (AMBP) were assessed using  Enzyme linked Immunosorbent assay (ELISA); creatinine, albumin and fasting blood glucose were determined spectrophotometrically.  HbA1c was estimated using FIA meter.

Results: The urinary DPPIV, HP15 and AMBP were positively and significantly related to the ACR  and HbA1c among T2DM patients. There was a significantly higher DPPIV, AMBP and HP15 in T2DM patients than in control subjects; in  microalbuminuric than normoalbumunuric T2DM patients and in normoalbuminuric T2DM patients than control subjects. There was a  positive and significant correlation between ACR and DPPIV (r=0.618, p=0.000); HP15 (r=0.598, p=0.000); AMBP (r=0.559, p=0.000). The  calculated area under curve (AUC) from receiver operating curve (ROC) found that DPP-IV (0.867), HP-15 (0.852) and AMBP (0.838)  revealed high specificity and sensitivity.

Conclusion: The exosomes showed their potentiality and promising as early diagnostic biomarkers of DN compared to microalbuminuria, having DPPIV as the most sensitive. Larger and multicentre prospective studies are  needed to confirm their clinical utility as a screening tool for every day practice.