Vaspin Levels and Diabetic Nephropathy in Elderly Patients with Type 2 Diabetes Mellitus

Abstract

Background: Diabetic nephropathy (DN) is a highly prevalent major chronic complications of DM. DN is diagnosed depending on clinical  background with existence of albuminuria and/or declined eGFR and hypertension without any other primary renal disease. Vaspin is an  adipokine, which acts as anti-atherogenic.

Objective: This study aimed to correlate vaspin levels to the biochemical findings in DM and DN, and to investigate the significance of  vaspin in predicting the development of DN among type 2 diabetic patients.

Subjects and methods: Our research involved 90 subjects  (above 65 years old) who were divided into 3 groups. Group I with 30 elderly healthy individuals, group II with 30 elderly uncomplicated  type 2 diabetic patients and group III included 30 elderly type 2 diabetic patients with DN.

Results: Statistically significant decreases in  vaspin levels among group III compared to groups I and II were detected. Also, group II had a statistically significant rise compared to  group I. Statistically significant positive correlations were detected between vaspin levels and each of fasting insulin (r=0.909, P<0.001),  HOMA-IR (r=0.902, P<0.001), C-peptide (r=0.721, P<0.001), and GFR (r=0.892, P<0.001). However, statistically significant negative  correlations were detected between vaspin levels and each of albumin/creatinine ratio (ACR) (r=-0.600, P=0.002), creatinine (r=-0.551,  P=0.002), and blood urea nitrogen (BUN) (r=-0.451, P=0.031) among group III. Receiver operating curve (ROC) showed that vaspin had a  significant validity in the prediction of DN among DM cases with sensitivity of 87%, specificity of 78.3% and accuracy of 82.6%.

Conclusion:  Vaspin could be a potential marker in the prediction of DN development among DM cases.