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Diagnostic Significance of Elabela, FABP1, and FABP2 as Biomarkers of Diabetic Nephropathy in Type 2 Diabetic Patients

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Indian Journal of Clinical Biochemistry Aims and scope Submit manuscript

Abstract

Among the side effects of diabetes mellitus is diabetic nephropathy, the main reason for end-stage kidney disease linked to increased mortality and morbidity. Early diagnostic biomarkers for diabetic nephropathy are required to stop or even slow down the progression of the disease and to administer the most appropriate protective treatments on time. Therefore, it is essential to study additional potential biomarkers for the early diagnosis of diabetic nephropathy. This study aims to evaluate elabela, FABP1, and FABP2 levels synergistically as a new diagnostic tool for the early detection of diabetic nephropathy in type 2 diabetic patients. This study was conducted on 95 subjects (75 patients with type 2 diabetes and 20 healthy controls). Type 2 diabetic patients were divided based on their urinary ACR into three groups: normal albuminuria, microalbuminuria (early nephropathy), and macroalbuminuria (overt nephropathy), and compared to healthy controls. Serum elabela, FABP1, and FABP2 levels and some biochemical parameters were evaluated. The level of serum elabela significantly decreased (P < 0.05), while FABP1 and FABP2 levels significantly increased (P < 0.05) with the increase in the severity of diabetic nephropathy compared to the control group. There were significant negative correlations between elabela and FABP1, FABP2, and urinary ACR and significant positive correlations with eGFR in all patient groups. FABP1 and FABP2 levels showed significant negative correlations with eGFR and significant positive correlations with urinary ACR. Multiple linear regression analysis illustrated a significant effect of urinary ACR on the three biomarkers in all studied groups. ROC curve analysis demonstrated that the combination of elabela, FABP1, and FABP2 had the highest diagnostic performance with an AUC of 1.0 (P = 0.001), and the sensitivity and specificity reached 100% in all patient groups compared to the control group. In conclusion, elabela, FABP1, and FABP2 may be potential new biomarkers of diabetic nephropathy. Combining these three biomarkers can be used synergistically as a diagnostic tool for the early diagnosis of diabetic nephropathy in type 2 diabetic patients.

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Data Availability

This study was carried out at the Clinical Pathology Department, Faculty of Medicine, El-Minia University Hospital. All data generated or analyzed during this study are included in this published article and its supplementary information file.

Abbreviations

ACR:

Albumin-to-creatinine ratio

AUC:

Area under the curve

DKD:

Diabetic kidney disease

eGFR:

Estimated glomerular filtration rate

ESKD:

End-stage kidney disease

FABP1:

Fatty acid-binding protein 1

FABP2:

Fatty acid-binding protein 2

HbA1c:

Glycosylated hemoglobin

MDRD:

Modification of diet in renal disease

ROC:

Receiver operating characteristic

T2DM:

Type 2 diabetes mellitus

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Authors and Affiliations

  1. Biochemistry Department, Faculty of Science, Ain Shams University, El-Khalifa El-Mamoun St., Abbassia, Cairo, 11566, Egypt

    Samah M. Mohamed, Kholoud S. Ramadan & Ehab A. Ibrahim

  2. Clinical Pathology Department, Faculty of Medicine, Minia University, Minya, Egypt

    Ahmed A. Saedii

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Contributions

SMM: Collected the samples, performed the experiment, and did data analysis. KSR and AAS: Contributed to conceptualization and supervision. EAI: Contributed to conceptualization, supervision, writing the original draft, and reviewing and editing the final manuscript. All authors read and approved the final version of the manuscript.

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Correspondence to Ehab A. Ibrahim.

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The authors declare that they have no competing interests.

Ethics Approval and Consent to Participate

The protocol of this study was approved by the Institutional Review Board, Faculty of Medicine, Minia University (MUFMIRB Approval No 802:6:2023) and complied with the tenets of the Declaration of Helsinki. All subjects signed informed consent.

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Mohamed, S.M., Ramadan, K.S., Saedii, A.A. et al. Diagnostic Significance of Elabela, FABP1, and FABP2 as Biomarkers of Diabetic Nephropathy in Type 2 Diabetic Patients. Ind J Clin Biochem (2024). https://doi.org/10.1007/s12291-024-01231-x

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